Saint Mary's Regional Medical Center — Pricing

754 procedures published in this hospital's Machine-Readable File (MRF) — 720 with a comparable price, 34 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 754
Lowest published price $2,722
Average published price $26,228
Highest published price $408,846

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 754 procedures

Published charges

Showing all 720 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above.

Across 41 procedures, this hospital's negotiated rates average ≈125% of what Medicare pays.

DRG Description Published price Cash price vs. NV median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $408,846 $408,846 $613,908 −33% $573,534 −29% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $305,516 $305,516 $459,024 −33% $461,389 −34% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $257,388 $257,388 $412,183 −38% $306,087 −16% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $232,583 $232,583 $355,255 −35% $371,366 −37% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $153,534 $153,534 $241,180 −36% $248,521 −38% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $142,402 $142,402 $204,997 −31% $182,314 −22% —
007 LUNG TRANSPLANT $142,045 $142,045 $212,893 −33% $170,608 −17% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $119,861 $119,861 $196,616 −39% $194,769 −38% —
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $118,499 $118,499 $183,842 −36% $196,346 −40% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $115,852 $115,852 $177,302 −35% $164,641 −30% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $115,261 $115,261 $162,493 −29% $208,939 −45% —
426 UnGrouped $113,968 $113,968 $189,537 −40% $142,326 −20% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $105,044 $105,044 $164,909 −36% $188,171 −44% —
850 UnGrouped $100,289 $100,289 $168,048 −40% $121,563 −18% —
231 CORONARY BYPASS WITH PTCA WITH MCC $92,300 $92,300 $142,360 −35% $147,227 −37% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $92,249 $92,249 $143,683 −36% $153,282 −40% —
429 UnGrouped $90,856 $90,856 $153,621 −41% $144,774 −37% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $87,831 $87,831 $141,568 −38% $148,686 −41% —
010 PANCREAS TRANSPLANT $86,877 $86,877 $144,934 −40% $99,940 −13% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $86,382 $86,382 $136,799 −37% $105,228 −18% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $85,181 $85,181 $134,323 −37% $144,569 −41% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $84,327 $84,327 $132,952 −37% $143,242 −41% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $81,368 $81,368 $125,716 −35% $120,573 −33% —
427 UnGrouped $77,455 $77,455 $132,794 −42% $132,794 −42% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $77,068 $77,068 $121,943 −37% $131,961 −42% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $75,872 $75,872 $117,542 −35% $148,832 −49% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $74,484 $74,484 $111,275 −33% $102,600 −27% —
447 UnGrouped $73,146 $73,146 $126,098 −42% $126,098 −42% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CCMCC $72,867 $72,867 $117,755 −38% $89,353 −18% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $72,744 $72,744 $117,143 −38% $125,242 −42% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $70,575 $70,575 $112,973 −38% $116,058 −39% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $70,474 $70,474 $111,482 −37% $123,995 −43% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $69,028 $69,028 $113,263 −39% $109,331 −37% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC $67,621 $67,621 $108,032 −37% $117,280 −42% —
317 UnGrouped $67,535 $67,535 $117,146 −42% $88,566 −24% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $67,229 $67,229 $106,657 −37% $98,912 −32% —
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $66,997 $66,997 $111,256 −40% $108,472 −38% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $66,693 $66,693 $105,236 −37% $115,839 −42% —
028 SPINAL PROCEDURES WITH MCC $66,377 $66,377 $104,467 −36% $113,077 −41% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CCMCC $65,905 $65,905 $103,531 −36% $98,260 −33% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CCMCC $65,905 $65,905 $103,531 −36% $81,176 −19% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $65,417 $65,417 $106,606 −39% $113,855 −43% ≈113% of Medicare
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CCMCC $64,968 $64,968 $101,890 −36% $103,455 −37% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $64,919 $64,919 $101,357 −36% $80,018 −19% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $64,263 $64,263 $102,806 −37% $112,062 −43% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $63,593 $63,593 $102,471 −38% $96,192 −34% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $62,695 $62,695 $101,996 −39% $107,355 −42% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $62,324 $62,324 $98,478 −37% $106,778 −42% —
653 MAJOR BLADDER PROCEDURES WITH MCC $60,911 $60,911 $95,352 −36% $104,583 −42% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $60,399 $60,399 $101,872 −41% $106,057 −43% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $60,399 $60,399 $94,655 −36% $85,566 −29% —
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $59,466 $59,466 $93,021 −36% $86,459 −31% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $59,032 $59,032 $101,662 −42% $89,207 −34% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $58,976 $58,976 $91,797 −36% $101,576 −42% —
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $58,970 $58,970 $95,984 −39% $90,401 −35% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $58,157 $58,157 $92,629 −37% $102,573 −43% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $57,903 $57,903 $92,806 −38% $111,320 −48% —
450 UnGrouped $56,315 $56,315 $99,943 −44% $99,943 −44% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $56,130 $56,130 $89,933 −38% $99,423 −44% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $55,715 $55,715 $96,507 −42% $96,507 −42% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $55,546 $55,546 $88,519 −37% $80,793 −31% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $54,768 $54,768 $84,275 −35% $77,055 −29% —
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $54,726 $54,726 $84,094 −35% $93,238 −41% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $54,704 $54,704 $87,229 −37% $93,172 −41% ≈133% of Medicare
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $54,510 $54,510 $88,531 −38% $96,905 −44% —
245 AICD GENERATOR PROCEDURES $53,465 $53,465 $83,679 −36% $72,076 −26% —
006 LIVER TRANSPLANT WITHOUT MCC $53,058 $53,058 $84,661 −37% $84,407 −37% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $52,260 $52,260 $82,379 −37% $90,724 −42% —
799 SPLENIC PROCEDURES WITH MCC $52,036 $52,036 $84,805 −39% $82,218 −37% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $52,026 $52,026 $75,210 −31% $90,775 −43% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $51,493 $51,493 $84,923 −39% $92,217 −44% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $51,221 $51,221 $80,569 −36% $87,761 −42% —
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $50,922 $50,922 $83,699 −39% $91,329 −44% —
163 MAJOR CHEST PROCEDURES WITH MCC $50,459 $50,459 $81,664 −38% $90,195 −44% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $50,439 $50,439 $81,065 −38% $71,551 −30% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CCMCC $50,280 $50,280 $82,142 −39% $90,331 −44% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $50,272 $50,272 $88,050 −43% $88,050 −43% ≈137% of Medicare
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $49,403 $49,403 $78,568 −37% $76,001 −35% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $49,112 $49,112 $77,348 −37% $84,692 −42% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $48,977 $48,977 $79,277 −38% $88,307 −45% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $48,525 $48,525 $77,090 −37% $70,177 −31% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $48,117 $48,117 $78,179 −38% $86,970 −45% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $47,403 $47,403 $80,049 −41% $59,352 −20% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CCMCC $47,307 $47,307 $77,759 −39% $83,441 −43% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $46,741 $46,741 $71,463 −35% $82,561 −43% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $46,672 $46,672 $75,291 −38% $101,510 −54% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $46,346 $46,346 $72,158 −36% $60,098 −23% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $45,928 $45,928 $73,394 −37% $72,962 −37% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $45,917 $45,917 $58,825 −22% $77,990 −41% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $45,710 $45,710 $66,954 −32% $18,649 +145% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $45,604 $45,604 $74,612 −39% $85,159 −46% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $45,078 $45,078 $73,264 −38% $82,247 −45% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $45,053 $45,053 $72,142 −38% $73,120 −38% —
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $44,987 $44,987 $71,772 −37% $79,836 −44% —
448 UnGrouped $44,768 $44,768 $81,998 −45% $81,998 −45% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $44,594 $44,594 $70,719 −37% $79,225 −44% —
791 PREMATURITY WITH MAJOR PROBLEMS $44,513 $44,513 $65,188 −32% $42,679 +4% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $43,688 $43,688 $59,175 −26% $77,817 −44% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $43,657 $43,657 $67,645 −35% $62,300 −30% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $43,276 $43,276 $70,523 −39% $71,795 −40% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $43,189 $43,189 $69,437 −38% $61,832 −30% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $43,102 $43,102 $68,136 −37% $54,196 −20% —
402 UnGrouped $42,914 $42,914 $79,116 −46% $79,116 −46% —
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $42,893 $42,893 $70,421 −39% $78,852 −46% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $42,659 $42,659 $69,137 −38% $76,219 −44% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $42,403 $42,403 $69,391 −39% $66,685 −36% —
904 SKIN GRAFTS FOR INJURIES WITH CCMCC $42,360 $42,360 $63,774 −34% $59,594 −29% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $42,243 $42,243 $64,552 −35% $75,573 −44% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $41,941 $41,941 $72,657 −42% $75,103 −44% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $41,717 $41,717 $67,514 −38% $74,755 −44% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $41,397 $41,397 $74,257 −44% $74,257 −44% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $41,071 $41,071 $60,861 −33% $61,470 −33% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $40,061 $40,061 $63,136 −37% $68,639 −42% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $39,787 $39,787 $70,005 −43% $71,755 −45% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $39,369 $39,369 $62,842 −37% $66,711 −41% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $39,367 $39,367 $62,708 −37% $59,533 −34% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $39,360 $39,360 $64,593 −39% $71,092 −45% —
265 AICD LEAD PROCEDURES $39,179 $39,179 $63,513 −38% $63,171 −38% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CCMCC $38,780 $38,780 $67,432 −42% $66,848 −42% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $38,770 $38,770 $60,547 −36% $50,919 −24% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $38,674 $38,674 $63,495 −39% $56,964 −32% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $38,480 $38,480 $59,170 −35% $66,068 −42% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $38,465 $38,465 $64,454 −40% $62,583 −39% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $38,398 $38,398 $51,953 −26% $51,953 −26% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $38,153 $38,153 $63,247 −40% $56,242 −32% —
332 RECTAL RESECTION WITH MCC $38,112 $38,112 $63,639 −40% $58,125 −34% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $38,071 $38,071 $61,634 −38% $52,036 −27% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $37,849 $37,849 $62,995 −40% $71,014 −47% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $37,791 $37,791 $68,653 −45% $68,653 −45% —
665 PROSTATECTOMY WITH MCC $37,732 $37,732 $58,850 −36% $54,072 −30% —
252 OTHER VASCULAR PROCEDURES WITH MCC $37,698 $37,698 $60,931 −38% $68,508 −45% ≈125% of Medicare
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $37,436 $37,436 $61,552 −39% $70,371 −47% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $37,282 $37,282 $62,546 −40% $70,132 −47% ≈120% of Medicare
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $36,900 $36,900 $60,899 −39% $67,268 −45% —
037 EXTRACRANIAL PROCEDURES WITH MCC $36,512 $36,512 $60,184 −39% $66,666 −45% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $36,306 $36,306 $60,762 −40% $52,908 −31% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $35,947 $35,947 $59,379 −39% $65,788 −45% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $35,846 $35,846 $59,397 −40% $58,745 −39% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $35,831 $35,831 $57,762 −38% $65,608 −45% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $35,412 $35,412 $58,678 −40% $72,424 −51% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $35,150 $35,150 $57,024 −38% $71,464 −51% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $35,084 $35,084 $55,308 −37% $49,710 −29% —
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CCMCC $34,991 $34,991 $58,865 −41% $44,472 −21% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $34,922 $34,922 $57,668 −39% $55,289 −37% —
500 SOFT TISSUE PROCEDURES WITH MCC $34,864 $34,864 $57,846 −40% $61,872 −44% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $34,348 $34,348 $58,564 −41% $65,573 −48% ≈105% of Medicare
662 MINOR BLADDER PROCEDURES WITH MCC $34,333 $34,333 $55,477 −38% $54,562 −37% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $34,189 $34,189 $57,955 −41% $65,325 −48% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $34,038 $34,038 $56,560 −40% $62,821 −46% —
451 UnGrouped $33,969 $33,969 $65,216 −48% $65,216 −48% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CCMCC $33,945 $33,945 $56,424 −40% $53,864 −37% —
652 KIDNEY TRANSPLANT $33,811 $33,811 $55,127 −39% $54,720 −38% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $33,781 $33,781 $56,803 −41% $60,407 −44% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $33,672 $33,672 $55,749 −40% $64,523 −48% —
570 SKIN DEBRIDEMENT WITH MCC $33,148 $33,148 $46,481 −29% $52,435 −37% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $32,889 $32,889 $46,402 −29% $46,402 −29% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $32,399 $32,399 $60,274 −46% $65,653 −51% ≈134% of Medicare
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $32,313 $32,313 $53,326 −39% $60,170 −46% —
668 TRANSURETHRAL PROCEDURES WITH MCC $32,132 $32,132 $52,343 −39% $51,608 −38% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $32,114 $32,114 $62,334 −48% $70,467 −54% —
800 SPLENIC PROCEDURES WITH CC $32,105 $32,105 $52,322 −39% $49,184 −35% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $32,087 $32,087 $52,237 −39% $59,790 −46% —
472 CERVICAL SPINAL FUSION WITH CC $31,925 $31,925 $53,272 −40% $59,537 −46% —
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $31,599 $31,599 $59,031 −46% $59,031 −46% —
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $31,563 $31,563 $58,975 −46% $58,975 −46% —
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $31,545 $31,545 $51,638 −39% $61,217 −48% —
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $31,502 $31,502 $51,082 −38% $49,839 −37% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIESINTRALUMINAL DEVICES $31,379 $31,379 $60,959 −49% $81,706 −62% ≈132% of Medicare
654 MAJOR BLADDER PROCEDURES WITH CC $31,112 $31,112 $50,914 −39% $58,274 −47% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $30,964 $30,964 $51,984 −40% $58,043 −47% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $30,932 $30,932 $51,679 −40% $52,986 −42% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $30,184 $30,184 $52,595 −43% $48,358 −38% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $30,131 $30,131 $47,228 −36% $50,618 −40% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $30,077 $30,077 $50,171 −40% $51,746 −42% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $29,971 $29,971 $48,225 −38% $43,491 −31% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $29,827 $29,827 $48,662 −39% $62,264 −52% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $29,731 $29,731 $49,857 −40% $44,546 −33% —
263 VEIN LIGATION AND STRIPPING $29,596 $29,596 $50,428 −41% $51,253 −42% —
849 RADIOTHERAPY $29,477 $29,477 $47,499 −38% $37,862 −22% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $29,387 $29,387 $48,866 −40% $47,945 −39% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $29,284 $29,284 $49,828 −41% $44,222 −34% —
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CCMCC $29,249 $29,249 $49,053 −40% $48,687 −40% —
503 FOOT PROCEDURES WITH MCC $29,212 $29,212 $48,992 −40% $47,540 −39% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CCMCC $28,960 $28,960 $54,929 −47% $54,929 −47% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $28,886 $28,886 $49,256 −41% $46,453 −38% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CCMCC $28,584 $28,584 $47,192 −39% $45,167 −37% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $28,537 $28,537 $47,729 −40% $52,178 −45% ≈111% of Medicare
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $28,207 $28,207 $44,548 −37% $38,878 −27% —
253 OTHER VASCULAR PROCEDURES WITH CC $28,199 $28,199 $47,163 −40% $57,454 −51% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $28,147 $28,147 $46,590 −40% $58,707 −52% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $28,005 $28,005 $56,278 −50% $39,173 −29% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $27,916 $27,916 $44,711 −38% $40,362 −31% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CCMCC $27,894 $27,894 $47,404 −41% $49,423 −44% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $27,669 $27,669 $40,772 −32% $39,973 −31% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CCMCC $27,649 $27,649 $46,988 −41% $55,162 −50% —
397 APPENDIX PROCEDURES WITH MCC $27,384 $27,384 $45,248 −39% $53,257 −49% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CCMCC $27,276 $27,276 $46,643 −42% $54,583 −50% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $27,080 $27,080 $39,339 −31% $12,229 +121% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $27,065 $27,065 $45,077 −40% $51,985 −48% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $26,846 $26,846 $51,645 −48% $59,421 −55% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $26,745 $26,745 $44,832 −40% $50,046 −47% —
135 SINUS AND MASTOID PROCEDURES WITH CCMCC $26,662 $26,662 $46,773 −43% $42,186 −37% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $26,553 $26,553 $51,189 −48% $59,651 −55% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $26,512 $26,512 $42,753 −38% $47,583 −44% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CCMCC $26,512 $26,512 $41,131 −36% $41,620 −36% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $26,288 $26,288 $49,915 −47% $53,451 −51% —
473 CERVICAL SPINAL FUSION WITHOUT CCMCC $26,189 $26,189 $44,886 −42% $50,624 −48% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $26,183 $26,183 $40,548 −35% $40,548 −35% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $26,149 $26,149 $50,562 −48% $59,500 −56% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $25,877 $25,877 $37,923 −32% $50,139 −48% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $25,678 $25,678 $36,237 −29% $36,489 −30% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $25,620 $25,620 $43,399 −41% $40,060 −36% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $25,396 $25,396 $39,714 −36% $40,108 −37% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $25,355 $25,355 $40,311 −37% $39,181 −35% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $25,279 $25,279 $41,562 −39% $42,415 −40% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CCMCC $25,232 $25,232 $42,480 −41% $48,349 −48% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $25,187 $25,187 $42,826 −41% $49,066 −49% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $25,091 $25,091 $40,767 −38% $41,892 −40% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CCMCC $25,008 $25,008 $41,956 −40% $38,998 −36% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $25,007 $25,007 $42,810 −42% $49,418 −49% —
113 ORBITAL PROCEDURES WITH CCMCC $24,990 $24,990 $44,320 −44% $36,167 −31% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $24,949 $24,949 $50,011 −50% $50,011 −50% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $24,909 $24,909 $42,316 −41% $47,737 −48% —
709 PENIS PROCEDURES WITH CCMCC $24,887 $24,887 $41,567 −40% $34,535 −28% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $24,728 $24,728 $41,929 −41% $47,789 −48% —
030 SPINAL PROCEDURES WITHOUT CCMCC $24,652 $24,652 $42,562 −42% $45,866 −46% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $24,521 $24,521 $44,489 −45% $46,283 −47% ≈139% of Medicare
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $24,370 $24,370 $41,659 −42% $41,608 −41% —
935 NON-EXTENSIVE BURNS $24,338 $24,338 $44,205 −45% $31,701 −23% —
906 HAND PROCEDURES FOR INJURIES $24,187 $24,187 $38,725 −38% $32,065 −25% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $24,149 $24,149 $37,957 −36% $45,333 −47% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $24,045 $24,045 $39,015 −38% $42,901 −44% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $23,915 $23,915 $40,605 −41% $45,877 −48% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $23,874 $23,874 $38,397 −38% $38,666 −38% —
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $23,819 $23,819 $40,328 −41% $37,267 −36% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $23,790 $23,790 $38,324 −38% $31,044 −23% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $23,774 $23,774 $38,303 −38% $38,070 −38% —
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $23,683 $23,683 $39,378 −40% $35,569 −33% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CCMCC $23,682 $23,682 $40,472 −41% $46,727 −49% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $23,680 $23,680 $40,494 −42% $46,724 −49% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $23,636 $23,636 $39,761 −41% $42,906 −45% —
333 RECTAL RESECTION WITH CC $23,568 $23,568 $39,819 −41% $37,154 −37% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $23,521 $23,521 $39,209 −40% $49,351 −52% —
595 MAJOR SKIN DISORDERS WITH MCC $23,458 $23,458 $38,718 −39% $34,598 −32% —
336 PERITONEAL ADHESIOLYSIS WITH CC $23,427 $23,427 $46,332 −49% $50,463 −54% —
374 DIGESTIVE MALIGNANCY WITH MCC $23,418 $23,418 $38,082 −39% $39,958 −41% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $23,418 $23,418 $34,471 −32% $43,650 −46% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $23,382 $23,382 $46,799 −50% $58,280 −60% —
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CCMCC $23,325 $23,325 $40,377 −42% $42,795 −45% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $23,256 $23,256 $38,598 −40% $46,066 −50% —
655 MAJOR BLADDER PROCEDURES WITHOUT CCMCC $23,049 $23,049 $39,638 −42% $43,174 −47% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $23,023 $23,023 $45,703 −50% $52,751 −56% —
592 SKIN ULCERS WITH MCC $22,821 $22,821 $37,547 −39% $33,246 −31% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CCMCC $22,725 $22,725 $38,201 −41% $35,030 −35% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $22,517 $22,517 $36,611 −38% $31,134 −28% —
539 OSTEOMYELITIS WITH MCC $22,454 $22,454 $36,419 −38% $37,609 −40% —
548 SEPTIC ARTHRITIS WITH MCC $22,370 $22,370 $36,083 −38% $31,346 −29% —
052 SPINAL DISORDERS AND INJURIES WITH CCMCC $22,347 $22,347 $36,025 −38% $32,031 −30% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $22,338 $22,338 $32,467 −31% $46,090 −52% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $22,194 $22,194 $37,882 −41% $44,363 −50% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $22,191 $22,191 $43,430 −49% $43,943 −50% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $22,176 $22,176 $38,436 −42% $29,611 −25% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $22,095 $22,095 $36,291 −39% $39,106 −43% ≈145% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $22,080 $22,080 $40,695 −46% $36,249 −39% —
100 SEIZURES WITH MCC $22,053 $22,053 $36,099 −39% $35,481 −38% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CCMCC $22,050 $22,050 $35,428 −38% $32,574 −32% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $21,919 $21,919 $37,712 −42% $43,800 −50% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $21,907 $21,907 $37,548 −42% $44,139 −50% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CCMCC $21,837 $21,837 $38,574 −43% $43,631 −50% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $21,801 $21,801 $37,559 −42% $35,628 −39% ≈120% of Medicare
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $21,792 $21,792 $43,538 −50% $43,538 −50% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $21,769 $21,769 $40,213 −46% $40,213 −46% ≈125% of Medicare
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $21,729 $21,729 $40,150 −46% $39,955 −46% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CCMCC $21,717 $21,717 $36,454 −40% $29,524 −26% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CCMCC $21,714 $21,714 $36,658 −41% $38,861 −44% —
707 MAJOR MALE PELVIC PROCEDURES WITH CCMCC $21,569 $21,569 $37,145 −42% $43,080 −50% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CCMCC $21,543 $21,543 $38,471 −44% $37,240 −42% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $21,471 $21,471 $42,881 −50% $42,881 −50% —
380 COMPLICATED PEPTIC ULCER WITH MCC $21,392 $21,392 $31,003 −31% $39,627 −46% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $21,268 $21,268 $36,033 −41% $34,459 −38% —
711 TESTES PROCEDURES WITH CCMCC $21,244 $21,244 $38,093 −44% $38,343 −45% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $21,103 $21,103 $36,032 −41% $42,126 −50% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $21,103 $21,103 $36,056 −41% $40,562 −48% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $21,057 $21,057 $39,105 −46% $36,431 −42% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $21,025 $21,025 $27,728 −24% $33,985 −38% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $20,997 $20,997 $39,013 −46% $33,255 −37% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $20,974 $20,974 $34,116 −39% $37,844 −45% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $20,972 $20,972 $41,840 −50% $50,607 −59% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CCMCC $20,971 $20,971 $41,855 −50% $47,711 −56% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $20,957 $20,957 $30,144 −30% $32,637 −36% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $20,751 $20,751 $33,823 −39% $36,792 −44% —
165 MAJOR CHEST PROCEDURES WITHOUT CCMCC $20,739 $20,739 $35,611 −42% $46,340 −55% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CCMCC $20,647 $20,647 $35,024 −41% $36,670 −44% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $20,630 $20,630 $34,134 −40% $23,206 −11% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $20,543 $20,543 $32,898 −38% $30,243 −32% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $20,502 $20,502 $34,541 −41% $29,221 −30% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $20,465 $20,465 $38,187 −46% $32,859 −38% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CCMCC $20,405 $20,405 $34,727 −41% $40,694 −50% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $20,351 $20,351 $34,958 −42% $43,298 −53% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $20,313 $20,313 $32,973 −38% $37,950 −46% —
919 COMPLICATIONS OF TREATMENT WITH MCC $20,302 $20,302 $37,933 −46% $31,105 −35% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $20,294 $20,294 $34,427 −41% $37,387 −46% ≈131% of Medicare
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $20,245 $20,245 $34,396 −41% $40,365 −50% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $20,244 $20,244 $36,991 −45% $37,842 −47% ≈116% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $20,147 $20,147 $33,584 −40% $32,433 −38% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CCMCC $20,097 $20,097 $34,587 −42% $41,591 −52% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $20,075 $20,075 $28,935 −31% $16,351 +23% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $20,009 $20,009 $32,116 −38% $26,510 −25% —
501 SOFT TISSUE PROCEDURES WITH CC $19,881 $19,881 $27,615 −28% $39,619 −50% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $19,840 $19,840 $33,496 −41% $52,075 −62% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $19,839 $19,839 $36,339 −45% $31,159 −36% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CCMCC $19,784 $19,784 $34,537 −43% $34,276 −42% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $19,754 $19,754 $33,972 −42% $38,101 −48% —
199 PNEUMOTHORAX WITH MCC $19,671 $19,671 $35,590 −45% $33,787 −42% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $19,589 $19,589 $34,360 −43% $39,020 −50% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CCMCC $19,587 $19,587 $33,348 −41% $39,018 −50% —
509 ARTHROSCOPY $19,578 $19,578 $38,998 −50% $25,994 −25% —
597 MALIGNANT BREAST DISORDERS WITH MCC $19,578 $19,578 $31,137 −37% $33,386 −41% —
504 FOOT PROCEDURES WITH CC $19,559 $19,559 $38,960 −50% $38,960 −50% —
505 FOOT PROCEDURES WITHOUT CCMCC $19,559 $19,559 $27,138 −28% $34,937 −44% —
582 MASTECTOMY FOR MALIGNANCY WITH CCMCC $19,518 $19,518 $33,285 −41% $35,849 −46% —
254 OTHER VASCULAR PROCEDURES WITHOUT CCMCC $19,499 $19,499 $33,217 −41% $38,836 −50% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $19,483 $19,483 $29,543 −34% $33,555 −42% ≈120% of Medicare
180 RESPIRATORY NEOPLASMS WITH MCC $19,481 $19,481 $27,647 −30% $36,658 −47% —
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $19,384 $19,384 $32,490 −40% $31,951 −39% —
915 ALLERGIC REACTIONS WITH MCC $19,374 $19,374 $32,355 −40% $32,645 −41% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $19,355 $19,355 $34,152 −43% $32,443 −40% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $19,277 $19,277 $33,083 −42% $29,826 −35% —
671 URETHRAL PROCEDURES WITH CCMCC $19,220 $19,220 $32,749 −41% $27,233 −29% —
075 VIRAL MENINGITIS WITH CCMCC $19,206 $19,206 $33,338 −42% $30,447 −37% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $19,137 $19,137 $32,545 −41% $38,094 −50% —
551 MEDICAL BACK PROBLEMS WITH MCC $19,033 $19,033 $31,518 −40% $34,017 −44% ≈123% of Medicare
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $18,976 $18,976 $37,764 −50% $43,477 −56% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $18,896 $18,896 $31,844 −41% $32,944 −43% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $18,860 $18,860 $31,576 −40% $29,079 −35% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $18,849 $18,849 $27,758 −32% $31,563 −40% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $18,795 $18,795 $30,784 −39% $34,273 −45% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $18,757 $18,757 $35,532 −47% $32,496 −42% ≈122% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CCMCC $18,689 $18,689 $31,918 −41% $29,916 −38% —
571 SKIN DEBRIDEMENT WITH CC $18,686 $18,686 $26,915 −31% $37,169 −50% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $18,641 $18,641 $27,949 −33% $26,682 −30% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $18,639 $18,639 $30,814 −40% $33,876 −45% —
116 INTRAOCULAR PROCEDURES WITH CCMCC $18,624 $18,624 $33,084 −44% $29,126 −36% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CCMCC $18,620 $18,620 $31,521 −41% $34,607 −46% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $18,571 $18,571 $35,243 −47% $32,628 −43% ≈132% of Medicare
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CCMCC $18,558 $18,558 $30,463 −39% $29,316 −37% —
334 RECTAL RESECTION WITHOUT CCMCC $18,516 $18,516 $31,176 −41% $36,820 −50% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $18,513 $18,513 $36,816 −50% $44,606 −58% —
643 ENDOCRINE DISORDERS WITH MCC $18,502 $18,502 $32,267 −43% $33,563 −45% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $18,488 $18,488 $35,113 −47% $34,192 −46% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CCMCC $18,433 $18,433 $31,624 −42% $44,117 −58% —
666 PROSTATECTOMY WITH CC $18,393 $18,393 $31,941 −42% $31,906 −42% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CCMCC $18,343 $18,343 $30,339 −40% $35,831 −49% —
801 SPLENIC PROCEDURES WITHOUT CCMCC $18,333 $18,333 $32,460 −44% $36,445 −50% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $18,329 $18,329 $27,561 −33% $30,828 −41% ≈135% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $18,311 $18,311 $34,742 −47% $30,235 −39% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $18,297 $18,297 $30,158 −39% $33,661 −46% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $18,288 $18,288 $31,778 −42% $36,354 −50% —
157 DENTAL AND ORAL DISEASES WITH MCC $18,287 $18,287 $30,978 −41% $31,300 −42% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $18,166 $18,166 $29,539 −39% $27,633 −34% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CCMCC $18,158 $18,158 $31,581 −43% $28,202 −36% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $18,150 $18,150 $24,927 −27% $27,617 −34% —
913 TRAUMATIC INJURY WITH MCC $18,079 $18,079 $29,130 −38% $24,198 −25% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $18,072 $18,072 $26,964 −33% $27,316 −34% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $18,060 $18,060 $30,714 −41% $33,707 −46% ≈118% of Medicare
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $18,053 $18,053 $35,872 −50% $27,152 −34% —
038 EXTRACRANIAL PROCEDURES WITH CC $18,004 $18,004 $30,611 −41% $35,770 −50% —
606 MINOR SKIN DISORDERS WITH MCC $17,993 $17,993 $30,253 −41% $27,975 −36% —
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CCMCC $17,966 $17,966 $35,692 −50% $35,692 −50% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CCMCC $17,913 $17,913 $30,836 −42% $35,584 −50% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $17,849 $17,849 $30,627 −42% $35,453 −50% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CCMCC $17,832 $17,832 $30,618 −42% $35,419 −50% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CCMCC $17,811 $17,811 $35,375 −50% $39,006 −54% —
183 MAJOR CHEST TRAUMA WITH MCC $17,744 $17,744 $33,957 −48% $29,933 −41% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CCMCC $17,734 $17,734 $33,853 −48% $41,955 −58% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $17,667 $17,667 $29,828 −41% $35,074 −50% —
186 PLEURAL EFFUSION WITH MCC $17,665 $17,665 $33,834 −48% $33,834 −48% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $17,629 $17,629 $28,645 −38% $32,697 −46% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CCMCC $17,582 $17,582 $29,742 −41% $34,906 −50% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $17,548 $17,548 $33,653 −48% $33,653 −48% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $17,535 $17,535 $29,335 −40% $33,633 −48% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CCMCC $17,506 $17,506 $29,997 −42% $34,749 −50% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $17,476 $17,476 $29,967 −42% $46,295 −62% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CCMCC $17,352 $17,352 $29,664 −42% $34,434 −50% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $17,337 $17,337 $29,046 −40% $32,877 −47% —
813 COAGULATION DISORDERS $17,318 $17,318 $24,815 −30% $33,296 −48% —
669 TRANSURETHRAL PROCEDURES WITH CC $17,313 $17,313 $29,386 −41% $34,354 −50% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $17,300 $17,300 $28,652 −40% $24,550 −30% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CCMCC $17,294 $17,294 $34,316 −50% $26,598 −35% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $17,292 $17,292 $28,662 −40% $30,010 −42% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CCMCC $17,179 $17,179 $33,071 −48% $39,211 −56% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $17,134 $17,134 $29,433 −42% $25,703 −33% —
663 MINOR BLADDER PROCEDURES WITH CC $17,095 $17,095 $28,558 −40% $33,103 −48% —
945 REHABILITATION WITH CCMCC $17,085 $17,085 $32,934 −48% $23,834 −28% —
533 FRACTURES OF FEMUR WITH MCC $17,068 $17,068 $29,426 −42% $25,945 −34% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CCMCC $16,982 $16,982 $27,694 −39% $33,674 −50% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CCMCC $16,906 $16,906 $27,847 −39% $30,770 −45% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $16,899 $16,899 $28,620 −41% $33,454 −49% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CCMCC $16,859 $16,859 $29,605 −43% $33,424 −50% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $16,847 $16,847 $33,399 −50% $36,505 −54% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CCMCC $16,842 $16,842 $28,465 −41% $36,253 −54% —
682 RENAL FAILURE WITH MCC $16,819 $16,819 $29,211 −42% $29,064 −42% ≈126% of Medicare
710 PENIS PROCEDURES WITHOUT CCMCC $16,814 $16,814 $26,981 −38% $26,436 −36% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $16,800 $16,800 $23,877 −30% $27,394 −39% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $16,789 $16,789 $32,473 −48% $30,502 −45% —
506 MAJOR THUMB OR JOINT PROCEDURES $16,789 $16,789 $32,280 −48% $30,557 −45% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $16,770 $16,770 $32,445 −48% $24,586 −32% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CCMCC $16,720 $16,720 $33,137 −50% $33,393 −50% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $16,676 $16,676 $28,781 −42% $33,048 −50% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CCMCC $16,609 $16,609 $28,060 −41% $36,988 −55% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $16,541 $16,541 $23,702 −30% $8,445 +96% —
865 VIRAL ILLNESS WITH MCC $16,538 $16,538 $32,083 −48% $26,910 −39% —
693 URINARY STONES WITH MCC $16,478 $16,478 $27,258 −40% $23,892 −31% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $16,473 $16,473 $27,607 −40% $30,571 −46% ≈127% of Medicare
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CCMCC $16,467 $16,467 $27,533 −40% $25,073 −34% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $16,467 $16,467 $28,880 −43% $26,463 −38% —
602 CELLULITIS WITH MCC $16,465 $16,465 $31,970 −48% $30,598 −46% ≈120% of Medicare
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $16,403 $16,403 $28,791 −43% $29,743 −45% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CCMCC $16,385 $16,385 $28,291 −42% $32,451 −50% —
637 DIABETES WITH MCC $16,325 $16,325 $31,753 −49% $30,100 −46% ≈121% of Medicare
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $16,310 $16,310 $27,135 −40% $24,941 −35% —
713 TRANSURETHRAL PROSTATECTOMY WITH CCMCC $16,214 $16,214 $27,591 −41% $32,100 −49% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $16,170 $16,170 $22,525 −28% $22,525 −28% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CCMCC $16,140 $16,140 $26,688 −40% $26,932 −40% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CCMCC $16,075 $16,075 $27,298 −41% $35,465 −55% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CCMCC $16,073 $16,073 $27,606 −42% $32,833 −51% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $15,948 $15,948 $26,424 −40% $27,808 −43% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CCMCC $15,925 $15,925 $27,064 −41% $22,620 −30% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $15,882 $15,882 $31,063 −49% $26,280 −40% —
088 CONCUSSION WITH MCC $15,832 $15,832 $27,694 −43% $24,402 −35% —
885 PSYCHOSES $15,820 $15,820 $30,492 −48% $21,729 −27% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CCMCC $15,768 $15,768 $27,270 −42% $39,887 −60% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CCMCC $15,730 $15,730 $26,657 −41% $22,393 −30% —
137 MOUTH PROCEDURES WITH CCMCC $15,701 $15,701 $27,494 −43% $27,861 −44% —
502 SOFT TISSUE PROCEDURES WITHOUT CCMCC $15,686 $15,686 $31,017 −49% $31,017 −49% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $15,612 $15,612 $26,107 −40% $27,285 −43% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $15,602 $15,602 $30,846 −49% $25,094 −38% —
150 EPISTAXIS WITH MCC $15,523 $15,523 $20,918 −26% $23,171 −33% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CCMCC $15,430 $15,430 $25,578 −40% $30,493 −49% —
139 SALIVARY GLAND PROCEDURES $15,424 $15,424 $24,689 −38% $23,612 −35% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CCMCC $15,393 $15,393 $30,418 −49% $30,418 −49% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $15,308 $15,308 $26,296 −42% $30,242 −49% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $15,230 $15,230 $25,230 −40% $30,083 −49% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CCMCC $15,217 $15,217 $25,813 −41% $29,949 −49% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $15,138 $15,138 $20,985 −28% $24,127 −37% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CCMCC $15,095 $15,095 $26,252 −43% $29,805 −49% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $15,066 $15,066 $25,579 −41% $31,264 −52% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $15,006 $15,006 $21,682 −31% $27,543 −46% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CCMCC $14,993 $14,993 $29,596 −49% $32,841 −54% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $14,957 $14,957 $29,523 −49% $24,552 −39% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $14,936 $14,936 $28,822 −48% $25,463 −41% ≈131% of Medicare
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $14,825 $14,825 $28,047 −47% $27,275 −46% ≈115% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CCMCC $14,824 $14,824 $29,250 −49% $36,937 −60% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $14,759 $14,759 $20,950 −30% $27,043 −45% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $14,698 $14,698 $28,993 −49% $26,051 −44% —
291 HEART FAILURE AND SHOCK WITH MCC $14,685 $14,685 $27,162 −46% $26,776 −45% ≈124% of Medicare
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $14,676 $14,676 $24,988 −41% $21,894 −33% —
540 OSTEOMYELITIS WITH CC $14,569 $14,569 $24,688 −41% $26,676 −45% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CCMCC $14,532 $14,532 $25,731 −44% $22,811 −36% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $14,520 $14,520 $25,130 −42% $27,989 −48% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $14,503 $14,503 $28,593 −49% $26,870 −46% —
947 SIGNS AND SYMPTOMS WITH MCC $14,484 $14,484 $28,553 −49% $27,401 −47% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $14,466 $14,466 $26,202 −45% $28,050 −48% ≈127% of Medicare
796 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH MCC $14,380 $14,380 $25,448 −43% $22,557 −36% —
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CCMCC $14,316 $14,316 $25,335 −43% $19,686 −27% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $14,316 $14,316 $23,752 −40% $23,498 −39% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CCMCC $14,290 $14,290 $24,863 −43% $28,156 −49% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $14,246 $14,246 $28,065 −49% $27,426 −48% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $14,228 $14,228 $28,029 −49% $22,320 −36% —
348 ANAL AND STOMAL PROCEDURES WITH CC $14,188 $14,188 $27,947 −49% $27,947 −49% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CCMCC $14,041 $14,041 $24,067 −42% $27,297 −49% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $14,039 $14,039 $23,062 −39% $19,354 −27% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $14,036 $14,036 $23,648 −41% $22,851 −39% —
642 INBORN AND OTHER DISORDERS OF METABOLISM $13,996 $13,996 $24,140 −42% $20,727 −32% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $13,968 $13,968 $19,152 −27% $22,458 −38% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $13,966 $13,966 $27,492 −49% $28,320 −51% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $13,956 $13,956 $26,542 −47% $26,580 −47% ≈119% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CCMCC $13,896 $13,896 $23,027 −40% $19,270 −28% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CCMCC $13,884 $13,884 $23,930 −42% $27,323 −49% —
375 DIGESTIVE MALIGNANCY WITH CC $13,861 $13,861 $27,277 −49% $27,277 −49% —
294 DEEP VEIN THROMBOPHLEBITIS WITH CCMCC $13,854 $13,854 $22,332 −38% $19,132 −28% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $13,806 $13,806 $23,023 −40% $27,163 −49% —
593 SKIN ULCERS WITH CC $13,796 $13,796 $23,196 −41% $22,886 −40% —
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CCMCC $13,758 $13,758 $23,410 −41% $25,581 −46% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CCMCC $13,701 $13,701 $26,948 −49% $26,948 −49% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $13,615 $13,615 $26,180 −48% $26,770 −49% ≈123% of Medicare
549 SEPTIC ARTHRITIS WITH CC $13,606 $13,606 $26,753 −49% $24,056 −43% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CCMCC $13,537 $13,537 $26,611 −49% $30,784 −56% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $13,499 $13,499 $22,469 −40% $21,847 −38% —
887 OTHER MENTAL DISORDER DIAGNOSES $13,436 $13,436 $20,867 −36% $20,616 −35% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CCMCC $13,386 $13,386 $22,862 −41% $25,712 −48% —
114 ORBITAL PROCEDURES WITHOUT CCMCC $13,357 $13,357 $22,920 −42% $19,598 −32% —
304 HYPERTENSION WITH MCC $13,278 $13,278 $26,080 −49% $26,080 −49% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $13,229 $13,229 $25,980 −49% $23,617 −44% ≈123% of Medicare
302 ATHEROSCLEROSIS WITH MCC $13,153 $13,153 $25,825 −49% $22,446 −41% —
121 ACUTE MAJOR EYE INFECTIONS WITH CCMCC $13,152 $13,152 $23,100 −43% $19,412 −32% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $13,151 $13,151 $22,272 −41% $23,443 −44% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CCMCC $13,126 $13,126 $23,145 −43% $21,230 −38% —
102 HEADACHES WITH MCC $13,112 $13,112 $22,470 −42% $25,740 −49% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $13,093 $13,093 $22,387 −42% $25,700 −49% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CCMCC $13,069 $13,069 $25,652 −49% $25,652 −49% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $13,020 $13,020 $21,326 −39% $18,133 −28% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CCMCC $12,941 $12,941 $22,549 −43% $25,390 −49% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $12,887 $12,887 $25,279 −49% $25,279 −49% —
039 EXTRACRANIAL PROCEDURES WITHOUT CCMCC $12,882 $12,882 $21,709 −41% $26,618 −52% —
152 OTITIS MEDIA AND URI WITH MCC $12,845 $12,845 $25,192 −49% $20,247 −37% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $12,769 $12,769 $22,031 −42% $24,566 −48% —
399 APPENDIX PROCEDURES WITHOUT CCMCC $12,726 $12,726 $24,948 −49% $31,321 −59% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $12,717 $12,717 $24,930 −49% $24,386 −48% ≈124% of Medicare
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $12,716 $12,716 $21,324 −40% $19,815 −36% —
946 REHABILITATION WITHOUT CCMCC $12,647 $12,647 $24,786 −49% $17,685 −28% —
181 RESPIRATORY NEOPLASMS WITH CC $12,580 $12,580 $21,081 −40% $23,573 −47% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $12,577 $12,577 $20,952 −40% $18,459 −32% —
200 PNEUMOTHORAX WITH CC $12,549 $12,549 $24,586 −49% $21,368 −41% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CCMCC $12,529 $12,529 $21,896 −43% $24,544 −49% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CCMCC $12,496 $12,496 $21,059 −41% $27,843 −55% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CCMCC $12,478 $12,478 $20,205 −38% $17,483 −29% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION ANDOR D&C $12,428 $12,428 $24,337 −49% $16,846 −26% —
672 URETHRAL PROCEDURES WITHOUT CCMCC $12,407 $12,407 $19,608 −37% $17,398 −29% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $12,371 $12,371 $20,644 −40% $20,926 −41% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $12,357 $12,357 $24,191 −49% $32,021 −61% —
381 COMPLICATED PEPTIC ULCER WITH CC $12,350 $12,350 $24,177 −49% $24,177 −49% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $12,300 $12,300 $24,075 −49% $23,319 −47% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $12,284 $12,284 $24,042 −49% $23,283 −47% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $12,263 $12,263 $20,025 −39% $17,226 −29% —
664 MINOR BLADDER PROCEDURES WITHOUT CCMCC $12,249 $12,249 $20,432 −40% $22,314 −45% —
949 AFTERCARE WITH CCMCC $12,241 $12,241 $20,511 −40% $23,953 −49% —
598 MALIGNANT BREAST DISORDERS WITH CC $12,240 $12,240 $21,512 −43% $19,073 −36% —
117 INTRAOCULAR PROCEDURES WITHOUT CCMCC $12,236 $12,236 $21,501 −43% $17,193 −29% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $12,208 $12,208 $18,298 −33% $18,956 −36% —
089 CONCUSSION WITH CC $12,166 $12,166 $23,800 −49% $18,821 −35% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $12,150 $12,150 $22,234 −45% $20,422 −41% —
712 TESTES PROCEDURES WITHOUT CCMCC $12,139 $12,139 $21,321 −43% $18,898 −36% —
184 MAJOR CHEST TRAUMA WITH CC $12,123 $12,123 $20,223 −40% $22,432 −46% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $12,055 $12,055 $23,571 −49% $23,571 −49% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $12,045 $12,045 $20,453 −41% $23,551 −49% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $12,021 $12,021 $19,912 −40% $24,914 −52% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $11,969 $11,969 $23,396 −49% $23,488 −49% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $11,956 $11,956 $23,369 −49% $20,232 −41% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CCMCC $11,947 $11,947 $20,154 −41% $19,657 −39% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $11,928 $11,928 $20,294 −41% $22,763 −48% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $11,845 $11,845 $16,321 −27% $23,141 −49% —
644 ENDOCRINE DISORDERS WITH CC $11,747 $11,747 $22,941 −49% $23,198 −49% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $11,721 $11,721 $22,759 −49% $22,888 −49% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $11,703 $11,703 $22,850 −49% $22,850 −49% —
667 PROSTATECTOMY WITHOUT CCMCC $11,686 $11,686 $19,760 −41% $16,703 −30% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CCMCC $11,673 $11,673 $19,730 −41% $25,970 −55% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CCMCC $11,654 $11,654 $19,615 −41% $18,348 −36% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $11,601 $11,601 $20,367 −43% $21,275 −45% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $11,601 $11,601 $19,362 −40% $17,601 −34% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $11,599 $11,599 $19,264 −40% $22,506 −48% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CCMCC $11,598 $11,598 $19,605 −41% $22,635 −49% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $11,594 $11,594 $22,628 −49% $20,901 −45% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $11,576 $11,576 $19,153 −40% $25,303 −54% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $11,568 $11,568 $21,739 −47% $23,940 −52% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $11,560 $11,560 $19,184 −40% $19,264 −40% —
920 COMPLICATIONS OF TREATMENT WITH CC $11,558 $11,558 $22,552 −49% $22,468 −49% —
187 PLEURAL EFFUSION WITH CC $11,429 $11,429 $22,288 −49% $21,789 −48% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $11,419 $11,419 $17,737 −36% $17,737 −36% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CCMCC $11,418 $11,418 $17,854 −36% $16,212 −30% —
697 URETHRAL STRICTURE $11,405 $11,405 $19,972 −43% $18,428 −38% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $11,384 $11,384 $22,197 −49% $20,957 −46% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $11,364 $11,364 $22,155 −49% $15,370 −26% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $11,304 $11,304 $18,747 −40% $22,033 −49% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $11,300 $11,300 $22,024 −49% $22,024 −49% —
197 INTERSTITIAL LUNG DISEASE WITH CC $11,277 $11,277 $18,927 −40% $21,941 −49% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $11,233 $11,233 $20,872 −46% $22,098 −49% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CCMCC $11,230 $11,230 $21,880 −49% $20,895 −46% —
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CCMCC $11,158 $11,158 $19,496 −43% $15,901 −30% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CCMCC $11,149 $11,149 $21,716 −49% $17,404 −36% —
797 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH CC $11,041 $11,041 $21,494 −49% $19,962 −45% —
798 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITHOUT CCMCC $11,041 $11,041 $17,388 −37% $18,452 −40% —
202 BRONCHITIS AND ASTHMA WITH CCMCC $11,025 $11,025 $18,350 −40% $17,724 −38% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $11,020 $11,020 $18,296 −40% $21,449 −49% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $10,994 $10,994 $20,617 −47% $21,396 −49% ≈129% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $10,977 $10,977 $15,382 −29% $21,363 −49% —
882 NEUROSES EXCEPT DEPRESSIVE $10,974 $10,974 $18,146 −40% $15,680 −30% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $10,937 $10,937 $18,236 −40% $17,733 −38% —
600 NON-MALIGNANT BREAST DISORDERS WITH CCMCC $10,916 $10,916 $18,778 −42% $16,700 −35% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CCMCC $10,910 $10,910 $17,930 −39% $19,924 −45% —
670 TRANSURETHRAL PROCEDURES WITHOUT CCMCC $10,906 $10,906 $18,267 −40% $20,911 −48% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CCMCC $10,900 $10,900 $17,657 −38% $19,594 −44% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $10,898 $10,898 $21,201 −49% $15,589 −30% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CCMCC $10,864 $10,864 $18,558 −41% $18,316 −41% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $10,750 $10,750 $20,263 −47% $20,181 −47% —
158 DENTAL AND ORAL DISEASES WITH CC $10,742 $10,742 $20,711 −48% $18,466 −42% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CCMCC $10,733 $10,733 $18,058 −41% $17,934 −40% —
779 ABORTION WITHOUT D&C $10,680 $10,680 $20,752 −49% $15,327 −30% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $10,667 $10,667 $20,725 −49% $16,968 −37% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $10,589 $10,589 $17,783 −40% $20,566 −49% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $10,559 $10,559 $20,506 −49% $20,506 −49% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $10,551 $10,551 $20,488 −49% $20,488 −49% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $10,539 $10,539 $17,493 −40% $20,463 −48% ≈144% of Medicare
101 SEIZURES WITHOUT MCC $10,538 $10,538 $17,468 −40% $20,461 −48% —
053 SPINAL DISORDERS AND INJURIES WITHOUT CCMCC $10,535 $10,535 $18,054 −42% $20,455 −48% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CCMCC $10,509 $10,509 $20,401 −48% $18,072 −42% —
638 DIABETES WITH CC $10,489 $10,489 $17,659 −41% $19,661 −47% —
076 VIRAL MENINGITIS WITHOUT CCMCC $10,486 $10,486 $17,519 −40% $17,135 −39% —
914 TRAUMATIC INJURY WITHOUT MCC $10,480 $10,480 $20,344 −48% $15,855 −34% —
881 DEPRESSIVE NEUROSES $10,456 $10,456 $17,360 −40% $15,058 −31% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CCMCC $10,439 $10,439 $17,733 −41% $20,259 −48% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $10,366 $10,366 $17,324 −40% $18,488 −44% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $10,355 $10,355 $19,630 −47% $16,552 −37% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CCMCC $10,354 $10,354 $20,084 −48% $20,084 −48% —
864 FEVER AND INFLAMMATORY CONDITIONS $10,281 $10,281 $19,935 −48% $18,640 −45% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $10,236 $10,236 $19,842 −48% $19,842 −48% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CCMCC $10,221 $10,221 $17,040 −40% $22,148 −54% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CCMCC $10,215 $10,215 $17,839 −43% $15,764 −35% —
683 RENAL FAILURE WITH CC $10,183 $10,183 $19,428 −48% $19,130 −47% —
866 VIRAL ILLNESS WITHOUT MCC $10,138 $10,138 $19,130 −47% $17,081 −41% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $10,136 $10,136 $19,638 −48% $15,452 −34% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CCMCC $10,130 $10,130 $19,624 −48% $16,520 −39% —
376 DIGESTIVE MALIGNANCY WITHOUT CCMCC $10,119 $10,119 $19,602 −48% $16,998 −40% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $10,110 $10,110 $19,584 −48% $16,699 −39% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $10,103 $10,103 $16,712 −40% $19,569 −48% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CCMCC $10,096 $10,096 $19,854 −49% $19,854 −49% —
603 CELLULITIS WITHOUT MCC $10,095 $10,095 $19,553 −48% $18,530 −46% —
541 OSTEOMYELITIS WITHOUT CCMCC $10,031 $10,031 $19,422 −48% $15,215 −34% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CCMCC $10,016 $10,016 $19,815 −49% $19,846 −50% —
312 SYNCOPE AND COLLAPSE $9,992 $9,992 $16,543 −40% $19,342 −48% ≈126% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $9,974 $9,974 $19,305 −48% $19,305 −48% —
607 MINOR SKIN DISORDERS WITHOUT MCC $9,915 $9,915 $16,703 −41% $15,889 −38% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $9,911 $9,911 $19,176 −48% $18,602 −47% —
550 SEPTIC ARTHRITIS WITHOUT CCMCC $9,893 $9,893 $17,077 −42% $19,138 −48% —
292 HEART FAILURE AND SHOCK WITH CC $9,883 $9,883 $19,118 −48% $16,371 −40% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $9,872 $9,872 $19,096 −48% $19,096 −48% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $9,860 $9,860 $19,072 −48% $18,807 −48% —
090 CONCUSSION WITHOUT CCMCC $9,841 $9,841 $16,952 −42% $15,412 −36% —
599 MALIGNANT BREAST DISORDERS WITHOUT CCMCC $9,815 $9,815 $14,842 −34% $14,290 −31% —
103 HEADACHES WITHOUT MCC $9,764 $9,764 $16,134 −39% $21,280 −54% —
594 SKIN ULCERS WITHOUT CCMCC $9,747 $9,747 $15,680 −38% $14,209 −31% —
182 RESPIRATORY NEOPLASMS WITHOUT CCMCC $9,626 $9,626 $15,651 −38% $14,064 −32% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CCMCC $9,619 $9,619 $16,168 −41% $14,055 −32% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $9,595 $9,595 $18,528 −48% $18,528 −48% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $9,498 $9,498 $15,512 −39% $17,298 −45% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $9,437 $9,437 $18,204 −48% $18,204 −48% —
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CCMCC $9,425 $9,425 $15,739 −40% $14,501 −35% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CCMCC $9,411 $9,411 $18,150 −48% $18,150 −48% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $9,399 $9,399 $18,126 −48% $18,126 −48% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CCMCC $9,399 $9,399 $18,126 −48% $18,126 −48% —
176 PULMONARY EMBOLISM WITHOUT MCC $9,377 $9,377 $17,081 −45% $18,081 −48% —
534 FRACTURES OF FEMUR WITHOUT MCC $9,372 $9,372 $16,142 −42% $17,559 −47% —
138 MOUTH PROCEDURES WITHOUT CCMCC $9,366 $9,366 $16,634 −44% $19,119 −51% —
204 RESPIRATORY SIGNS AND SYMPTOMS $9,339 $9,339 $15,548 −40% $18,004 −48% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $9,338 $9,338 $18,002 −48% $18,002 −48% —
123 NEUROLOGICAL EYE DISORDERS $9,255 $9,255 $17,831 −48% $19,745 −53% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $9,248 $9,248 $17,599 −47% $17,674 −48% ≈136% of Medicare
389 GASTROINTESTINAL OBSTRUCTION WITH CC $9,238 $9,238 $17,770 −48% $17,578 −47% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CCMCC $9,228 $9,228 $17,775 −48% $13,586 −32% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $9,221 $9,221 $17,762 −48% $21,056 −56% ≈153% of Medicare
446 DISORDERS OF THE BILIARY TRACT WITHOUT CCMCC $9,191 $9,191 $16,781 −45% $17,700 −48% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $9,161 $9,161 $17,638 −48% $17,921 −49% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CCMCC $9,104 $9,104 $17,522 −48% $17,620 −48% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $9,019 $9,019 $16,761 −46% $17,038 −47% ≈124% of Medicare
694 URINARY STONES WITHOUT MCC $9,019 $9,019 $17,347 −48% $17,345 −48% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $9,007 $9,007 $17,322 −48% $17,322 −48% —
645 ENDOCRINE DISORDERS WITHOUT CCMCC $8,990 $8,990 $17,287 −48% $15,428 −42% —
185 MAJOR CHEST TRAUMA WITHOUT CCMCC $8,979 $8,979 $17,265 −48% $17,124 −48% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CCMCC $8,892 $8,892 $12,137 −27% $14,648 −39% —
151 EPISTAXIS WITHOUT MCC $8,766 $8,766 $14,546 −40% $13,032 −33% —
305 HYPERTENSION WITHOUT MCC $8,687 $8,687 $14,686 −41% $18,086 −52% —
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CCMCC $8,681 $8,681 $16,654 −48% $19,037 −54% —
382 COMPLICATED PEPTIC ULCER WITHOUT CCMCC $8,671 $8,671 $14,338 −40% $16,634 −48% —
149 DYSEQUILIBRIUM $8,652 $8,652 $14,223 −39% $18,096 −52% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $8,651 $8,651 $11,740 −26% $12,895 −33% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $8,638 $8,638 $14,828 −42% $16,565 −48% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $8,618 $8,618 $14,077 −39% $15,019 −43% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $8,582 $8,582 $14,111 −39% $16,450 −48% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $8,563 $8,563 $16,331 −48% $17,303 −51% ≈139% of Medicare
188 PLEURAL EFFUSION WITHOUT CCMCC $8,508 $8,508 $14,091 −40% $14,514 −41% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $8,447 $8,447 $14,530 −42% $12,768 −34% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CCMCC $8,413 $8,413 $16,104 −48% $16,767 −50% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CCMCC $8,409 $8,409 $16,097 −48% $19,227 −56% ≈151% of Medicare
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CCMCC $8,400 $8,400 $14,250 −41% $12,593 −33% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $8,393 $8,393 $16,064 −48% $13,275 −37% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CCMCC $8,350 $8,350 $10,992 −24% $12,559 −34% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $8,284 $8,284 $15,839 −48% $12,454 −33% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CCMCC $8,283 $8,283 $13,566 −39% $15,837 −48% —
313 CHEST PAIN $8,283 $8,283 $15,837 −48% $16,440 −50% —
153 OTITIS MEDIA AND URI WITHOUT MCC $8,264 $8,264 $13,746 −40% $14,583 −43% —
297 CARDIAC ARREST, UNEXPLAINED WITH CC $8,185 $8,185 $13,617 −40% $12,336 −34% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CCMCC $8,167 $8,167 $11,374 −28% $15,600 −48% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CCMCC $8,142 $8,142 $13,962 −42% $15,549 −48% —
311 ANGINA PECTORIS $8,119 $8,119 $15,502 −48% $15,502 −48% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CCMCC $8,116 $8,116 $13,665 −41% $15,495 −48% —
203 BRONCHITIS AND ASTHMA WITHOUT CCMCC $8,101 $8,101 $15,464 −48% $12,252 −34% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CCMCC $8,100 $8,100 $15,462 −48% $12,460 −35% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CCMCC $8,075 $8,075 $11,262 −28% $14,797 −45% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $8,049 $8,049 $13,183 −39% $14,689 −45% —
921 COMPLICATIONS OF TREATMENT WITHOUT CCMCC $8,004 $8,004 $13,185 −39% $14,415 −44% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CCMCC $7,950 $7,950 $13,090 −39% $13,651 −42% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CCMCC $7,903 $7,903 $13,454 −41% $11,997 −34% —
303 ATHEROSCLEROSIS WITHOUT MCC $7,839 $7,839 $14,927 −47% $14,927 −47% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CCMCC $7,829 $7,829 $13,093 −40% $11,909 −34% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CCMCC $7,777 $7,777 $13,294 −41% $11,847 −34% —
916 ALLERGIC REACTIONS WITHOUT MCC $7,749 $7,749 $14,743 −47% $13,942 −44% —
159 DENTAL AND ORAL DISEASES WITHOUT CCMCC $7,700 $7,700 $14,643 −47% $13,633 −44% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CCMCC $7,698 $7,698 $12,966 −41% $14,638 −47% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CCMCC $7,566 $7,566 $12,591 −40% $14,368 −47% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $7,488 $7,488 $12,242 −39% $14,250 −47% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CCMCC $7,459 $7,459 $14,148 −47% $12,078 −38% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CCMCC $7,452 $7,452 $14,134 −47% $15,038 −50% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $7,449 $7,449 $12,218 −39% $14,128 −47% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CCMCC $7,422 $7,422 $11,856 −37% $11,421 −35% —
639 DIABETES WITHOUT CCMCC $7,343 $7,343 $13,373 −45% $13,910 −47% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $7,316 $7,316 $13,855 −47% $12,324 −41% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CCMCC $7,301 $7,301 $13,824 −47% $13,824 −47% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CCMCC $7,218 $7,218 $13,683 −47% $15,183 −52% —
684 RENAL FAILURE WITHOUT CCMCC $7,135 $7,135 $13,536 −47% $13,642 −48% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $7,130 $7,130 $9,894 −28% $11,071 −36% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CCMCC $7,050 $7,050 $11,842 −40% $10,975 −36% —
950 AFTERCARE WITHOUT CCMCC $6,905 $6,905 $11,846 −42% $13,527 −49% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $6,698 $6,698 $11,405 −41% $10,160 −34% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CCMCC $6,637 $6,637 $10,587 −37% $10,480 −37% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CCMCC $6,617 $6,617 $12,549 −47% $13,384 −51% —
293 HEART FAILURE AND SHOCK WITHOUT CCMCC $6,500 $6,500 $13,326 −51% $12,999 −50% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CCMCC $6,483 $6,483 $13,318 −51% $13,361 −51% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CCMCC $6,187 $6,187 $11,279 −45% $9,940 −38% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CCMCC $5,341 $5,341 $9,875 −46% $8,927 −40% —
795 NORMAL NEWBORN $2,722 $2,722 $3,213 −15% $4,720 −42% —

Procedures with negotiated rates only

These 34 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 UnGrouped $9,971 – $102,911 · median $50,907 8 plans
223 UnGrouped $9,971 – $102,911 · median $50,907 8 plans
224 UnGrouped $9,971 – $94,535 · median $50,907 8 plans
225 UnGrouped $9,971 – $94,535 · median $50,907 8 plans
226 UnGrouped $9,971 – $93,508 · median $50,900 8 plans
227 UnGrouped $9,971 – $93,508 · median $50,900 8 plans
230 UnGrouped $9,971 – $114,705 · median $69,398 6 plans
246 UnGrouped $9,971 – $40,518 · median $31,219 4 plans
247 UnGrouped $9,971 – $40,518 · median $35,828 4 plans
248 UnGrouped $9,971 – $40,518 · median $31,219 4 plans
249 UnGrouped $9,971 – $40,518 · median $35,828 4 plans
767 UnGrouped $5,779 – $12,228 · median $7,427 4 plans
454 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC $37,611 – $66,293 · median $60,330 3 plans
455 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CCMCC $23,986 – $43,913 · median $43,179 3 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $10,725 – $35,662 · median $19,308 3 plans
765 UnGrouped $8,668 – $12,228 · median $9,714 3 plans
766 UnGrouped $8,668 – $12,228 · median $9,714 3 plans
774 UnGrouped $5,779 – $12,228 · median $6,476 3 plans
775 UnGrouped $5,779 – $12,228 · median $6,476 3 plans
237 UnGrouped $6,003 – $9,971 · median $7,987 2 plans
238 UnGrouped $6,003 – $9,971 · median $7,987 2 plans
763 UnGrouped $7,391 – $12,228 · median $9,809 2 plans
771 UnGrouped $10,566 – $12,228 · median $11,397 2 plans
772 UnGrouped $8,771 – $12,228 · median $10,500 2 plans
773 UnGrouped $7,434 – $12,228 · median $9,831 2 plans
751 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
752 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
753 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
777 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
778 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
780 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
781 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
782 UnGrouped $12,228 – $12,228 · median $12,228 1 plans
999 UNGROUPABLE $3,649 – $3,649 · median $3,649 1 plans
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