Montefiore St. Luke's Cornwall — Pricing

770 procedures published in this hospital's Machine-Readable File (MRF) — 757 with a comparable price, 13 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 770
Lowest published price $1,606
Average published price $18,164
Highest published price $293,431

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 770 procedures

Published charges

Showing all 757 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 52 procedures, this hospital's negotiated rates average ≈121% of what Medicare pays.

DRG Description Published price Cash price vs. NY median vs. National median vs Medicare
018 Chimeric antigen receptor CAR T cell and other immunotherapies $293,431 $293,431 $483,987 −39% $573,534 −49% —
001 Heart transplant or implant of heart assist system with MCC $215,825 $215,825 $519,143 −58% $461,389 −53% —
927 Extensive burns or full thickness burns w MV 96 hours w skin graft $209,932 $209,932 $306,087 −31% $306,087 −31% —
003 ECMO or trach w MV 96 hrs or PDX exc face mouth neck w maj O R $169,804 $169,804 $374,499 −55% $371,366 −54% —
004 Trach w MV 96 hrs or PDX exc face mouth neck w o maj O R $117,077 $117,077 $227,105 −48% $248,521 −53% —
007 Lung transplant $97,695 $97,695 $170,608 −43% $170,608 −43% —
002 Heart transplant or implant of heart assist system without MCC $97,517 $97,517 $155,461 −37% $194,769 −50% —
014 Allogeneic bone marrow transplant $91,279 $91,279 $171,028 −47% $182,314 −50% —
212 Concomitant aortic and mitral valve procedures $85,782 $85,782 $312,843 −73% $196,346 −56% —
005 Liver transplant with MCC or intestinal transplant $82,432 $82,432 $139,842 −41% $164,641 −50% —
215 Other heart assist system implant $81,355 $81,355 $219,233 −63% $208,939 −61% —
216 Cardiac valve oth maj cardiothoracic proc w cardiac cath w MCC $77,297 $77,297 $200,973 −62% $188,171 −59% —
020 Intracranial vascular procedures with PDX hemorrhage w MCC $67,318 $67,318 $140,167 −52% $148,686 −55% —
456 Spinal fusion exc cerv w spinal curv malig infec ext fusion w MCC $67,135 $67,135 $99,515 −33% $153,282 −56% —
231 Coronary bypass with PTCA with MCC $64,633 $64,633 $170,222 −62% $147,227 −56% —
019 Simultaneous pancreas and kidney transplant with hemodialysis $63,664 $63,664 $105,228 −39% $105,228 −39% —
233 Coronary bypass with cardiac cath or open ablation with MCC $62,119 $62,119 $168,806 −63% $144,569 −57% —
219 Cardiac valve oth maj cardiothoracic proc w o cardiac cath w MCC $61,415 $61,415 $168,544 −64% $143,242 −57% —
957 Other O R procedures for multiple significant trauma with MCC $57,603 $57,603 $99,339 −42% $120,573 −52% —
275 Cardiac defibrillator implant with cardiac catheterization and MCC $56,036 $56,036 $157,998 −65% $131,961 −58% —
870 Septicemia or severe sepsis with MV 96 hours $55,471 $55,471 $175,904 −68% $148,832 −63% —
928 Full thickness burn w skin graft or inhalation injury w CC MCC $55,111 $55,111 $89,353 −38% $89,353 −38% —
207 Respiratory system diagnosis with ventilator support 96 hours $55,018 $55,018 $100,570 −45% $116,058 −53% —
969 HIV with extensive O R procedures with MCC $54,736 $54,736 $87,759 −38% $109,331 −50% —
268 Aortic and heart assist procedures except pulsation balloon w MCC $54,594 $54,594 $176,641 −69% $125,242 −56% —
461 Bilateral or multiple major joint procs of lower extremity w MCC $54,305 $54,305 $82,458 −34% $108,472 −50% —
217 Cardiac valve oth maj cardiothoracic proc w cardiac cath w CC $50,696 $50,696 $178,834 −72% $123,995 −59% —
266 Endovascular cardiac valve replacement supplement procedure w MCC $49,747 $49,747 $149,605 −67% $113,855 −56% —
573 Skin graft for skin ulcer or cellulitis with MCC $49,524 $49,524 $82,731 −40% $98,912 −50% —
276 Cardiac defibrillator implant with MCC or carotid sinus neurostimulators $49,461 $49,461 $102,983 −52% $117,280 −58% —
016 Autologous bone marrow transplant with CC MCC $49,196 $49,196 $81,176 −39% $98,260 −50% —
017 Autologous bone marrow transplant without CC MCC $49,196 $49,196 $81,176 −39% $81,176 −39% —
021 Intracranial vascular procedures with PDX hemorrhage w CC $48,913 $48,913 $118,645 −59% $106,057 −54% —
955 Craniotomy for multiple significant trauma $48,505 $48,505 $91,253 −47% $102,600 −53% —
457 Spinal fusion exc cerv w spinal curv malig infec ext fusion w CC $48,386 $48,386 $111,217 −56% $107,355 −55% —
820 Lymphoma and leukemia with major O R procedures with MCC $48,158 $48,158 $78,460 −39% $96,192 −50% —
028 Spinal procedures with MCC $47,994 $47,994 $165,843 −71% $113,077 −58% —
790 Extreme immaturity or respiratory distress syndrome neonate $47,787 $47,787 $66,974 −29% $80,018 −40% —
232 Coronary bypass with PTCA without MCC $47,377 $47,377 $173,445 −73% $115,839 −59% —
235 Coronary bypass without cardiac catheterization with MCC $46,836 $46,836 $149,185 −69% $112,062 −58% —
218 Cardiac valve oth maj cardiothoracic proc w card cath w o CC MCC $45,371 $45,371 $115,106 −61% $103,455 −56% —
576 Skin graft except for skin ulcer or cellulitis with MCC $45,263 $45,263 $106,393 −57% $90,401 −50% —
023 Craniot w maj dev impl acute CNS PDX w MCC or chemo epilep w neuros $45,149 $45,149 $122,419 −63% $106,778 −58% —
463 Wnd debride skn grft exc hand for musculoskel conn tis dis w MCC $45,108 $45,108 $74,690 −40% $89,207 −49% —
834 Acute leukemia with MCC $44,593 $44,593 $74,709 −40% $85,566 −48% —
405 Pancreas liver and shunt procedures with MCC $43,846 $43,846 $81,105 −46% $102,128 −57% —
653 Major bladder procedures with MCC $43,116 $43,116 $94,497 −54% $104,583 −59% —
008 Simultaneous pancreas and kidney transplant $41,906 $41,906 $86,459 −52% $86,459 −52% —
220 Cardiac valve oth maj cardiothoracic proc w o cardiac cath w CC $41,770 $41,770 $124,145 −66% $111,320 −62% —
234 Coronary bypass with cardiac cath or open ablation without MCC $41,398 $41,398 $129,059 −68% $102,573 −60% —
466 Revision of hip or knee replacement with MCC $41,308 $41,308 $80,478 −49% $96,507 −57% —
011 Tracheostomy for face mouth neck diagnoses or laryngectomy w MCC $41,067 $41,067 $143,271 −71% $101,576 −60% —
326 Stomach esophageal and duodenal procedures with MCC $40,451 $40,451 $69,008 −41% $80,793 −50% —
270 Other major cardiovascular procedures with MCC $40,275 $40,275 $111,594 −64% $99,423 −59% —
228 Other cardiothoracic procedures with MCC $40,130 $40,130 $101,409 −60% $96,905 −59% —
853 Infectious and parasitic diseases with O R procedures with MCC $39,817 $39,817 $96,196 −59% $93,172 −57% ≈114% of Medicare
799 Splenic procedures with MCC $39,461 $39,461 $76,574 −48% $82,218 −52% —
471 Cervical spinal fusion with MCC $39,177 $39,177 $72,015 −46% $92,515 −58% —
267 Endovascular cardiac valve replace supplement procedure w o MCC $38,868 $38,868 $140,473 −72% $92,217 −58% —
837 Chemo w acute leukemia as SDX or w high dose chemo agent w MCC $38,580 $38,580 $68,095 −43% $77,055 −50% —
006 Liver transplant without MCC $38,523 $38,523 $84,407 −54% $84,407 −54% —
010 Pancreas transplant $38,338 $38,338 $99,940 −62% $99,940 −62% —
239 Amputation for circulatory sys disorders exc upper limb toe w MCC $38,283 $38,283 $68,473 −44% $93,390 −59% —
277 Cardiac defibrillator implant without MCC $38,089 $38,089 $112,801 −66% $91,329 −58% —
981 Extensive O R procedures unrelated to principal diagnosis w MCC $37,755 $37,755 $105,908 −64% $90,775 −58% —
163 Major chest procedures with MCC $37,541 $37,541 $90,851 −59% $90,195 −58% —
221 Cardiac valve oth maj cardiothorac proc w o card cath w o CC MCC $37,023 $37,023 $100,943 −63% $90,331 −59% —
826 Myeloprolif disord or poorly diff neopl w maj O R proc w MCC $36,857 $36,857 $70,272 −48% $90,724 −59% —
245 AICD generator procedures $36,090 $36,090 $65,480 −45% $72,076 −50% —
458 Spinal fus exc cerv w spinal curv malig infec ext fusion w o CC MCC $36,087 $36,087 $79,183 −54% $83,441 −57% —
329 Major small and large bowel procedures with MCC $35,974 $35,974 $69,268 −48% $88,050 −59% —
823 Lymphoma and non acute leukemia with other procedures with MCC $35,855 $35,855 $88,519 −59% $87,761 −59% —
650 Kidney transplant with hemodialysis with MCC $35,820 $35,820 $62,992 −43% $71,551 −50% —
278 US accelerated other thrombolysis of peripheral vasc structures w MCC $35,525 $35,525 $106,019 −66% $93,238 −62% —
856 Postoperative or post traumatic infections w O R procedures w MCC $35,270 $35,270 $61,750 −43% $76,001 −54% —
025 Craniotomy and endovascular intracranial procedures with MCC $35,171 $35,171 $94,677 −63% $88,307 −60% —
319 Other endovascular cardiac valve procedures with MCC $34,740 $34,740 $87,760 −60% $86,970 −60% —
901 Wound debridements for injuries with MCC $34,468 $34,468 $60,697 −43% $70,177 −51% —
474 Amputation for musculoskeletal syst connective tissue dis w MCC $34,269 $34,269 $94,887 −64% $84,692 −60% —
356 Other digestive system O R procedures with MCC $34,077 $34,077 $108,198 −69% $82,561 −59% —
793 Full term neonate with major problems $33,525 $33,525 $13,828 +142% $18,649 +80% —
269 Aortic and heart assist procedures except pulsation balloon w o MCC $33,121 $33,121 $102,713 −68% $85,159 −61% —
323 Coronary intravascular lithotripsy with intraluminal device with MCC $32,973 $32,973 $102,919 −68% $101,510 −68% —
031 Ventricular shunt procedures with MCC $32,786 $32,786 $58,786 −44% $72,962 −55% —
791 Prematurity with major problems $32,636 $32,636 $39,563 −18% $42,679 −24% —
166 Other respiratory system O R procedures with MCC $32,318 $32,318 $65,839 −51% $75,573 −57% —
958 Other O R procedures for multiple significant trauma with CC $32,214 $32,214 $56,535 −43% $73,120 −56% —
236 Coronary bypass without cardiac catheterization without MCC $32,186 $32,186 $109,137 −71% $82,247 −61% —
628 Other endocrine nutritional and metabolic O R procedures with MCC $31,973 $31,973 $68,006 −53% $71,795 −55% —
012 Tracheostomy for face mouth neck diagnoses or laryngectomy w CC $31,897 $31,897 $119,835 −73% $79,836 −60% —
616 Amputation lower limb for endocrine nutrit metabolic disord w MCC $31,521 $31,521 $54,631 −42% $66,685 −53% —
022 Intracranial vascular procedures with PDX hemorrhage w o CC MCC $31,242 $31,242 $49,015 −36% $66,848 −53% —
423 Other hepatobiliary or pancreas O R procedures with MCC $31,148 $31,148 $55,985 −44% $79,225 −61% —
034 Carotid artery stent procedures with MCC $31,072 $31,072 $53,665 −42% $76,219 −59% —
273 Percutaneous and other intracardiac procedures with MCC $31,037 $31,037 $104,086 −70% $78,852 −61% —
736 Uterine adnexa procedures for ovarian or adnexal malignancy w MCC $30,959 $30,959 $54,300 −43% $61,832 −50% —
956 Limb reattachment hip femur proc for multiple significant trauma $30,888 $30,888 $61,356 −50% $75,103 −59% —
040 Peripheral cranial nerve and other nervous system procedures w MCC $30,667 $30,667 $58,978 −48% $74,257 −59% —
622 Skin grafts wound debride for endocrine nutrit metab disord w MCC $30,469 $30,469 $51,761 −41% $61,470 −50% —
024 Craniotomy w major device implant or acute complex CNS PDX w o MCC $30,176 $30,176 $73,716 −59% $74,755 −60% —
140 Major head and neck procedures with MCC $30,090 $30,090 $58,085 −48% $60,098 −50% —
876 O R procedures with principal diagnosis of mental illness $29,719 $29,719 $51,525 −42% $54,196 −45% —
408 Biliary tract proc except only cholecystect w or w o C D E w MCC $29,645 $29,645 $74,451 −60% $62,583 −53% —
907 Other O R procedures for injuries with MCC $29,624 $29,624 $75,408 −61% $77,817 −62% —
673 Other kidney and urinary tract procedures with MCC $29,452 $29,452 $68,137 −57% $77,990 −62% —
332 Rectal resection with MCC $29,104 $29,104 $48,214 −40% $58,125 −50% —
518 Back neck proc exc spinal fusion w MCC or disc device neurostim $29,084 $29,084 $76,715 −62% $71,092 −59% —
097 Non bacterial infect of nervous syst except viral meningitis w MCC $28,966 $28,966 $49,718 −42% $59,533 −51% —
094 Bacterial and tuberculous infections of nervous system with MCC $28,853 $28,853 $85,236 −66% $68,639 −58% —
739 Uterine adnexa proc for non ovarian non adnexal malignancy w MCC $28,802 $28,802 $54,862 −48% $62,300 −54% —
495 Local excision removal inter fixation dev exc hip femur w MCC $28,522 $28,522 $48,887 −42% $56,964 −50% —
335 Peritoneal adhesiolysis with MCC $28,473 $28,473 $56,742 −50% $71,755 −60% —
265 AICD lead procedures $28,147 $28,147 $49,492 −43% $63,171 −55% —
414 Cholecystectomy except by laparoscope without C D E with MCC $28,076 $28,076 $48,670 −42% $69,743 −60% —
467 Revision of hip or knee replacement with CC $27,766 $27,766 $67,788 −59% $70,847 −61% —
492 Lower extremity humerus procedures exc hip foot and femur w MCC $27,574 $27,574 $61,083 −55% $70,564 −61% —
651 Kidney transplant with hemodialysis without MCC $27,544 $27,544 $56,242 −51% $56,242 −51% —
271 Other major cardiovascular procedures with CC $27,527 $27,527 $81,781 −66% $71,014 −61% —
242 Permanent cardiac pacemaker implant with MCC $27,518 $27,518 $62,843 −56% $70,132 −61% —
802 Other O R procedures of the blood and blood forming organs w MCC $27,324 $27,324 $72,168 −62% $66,711 −59% —
029 Spinal procedures with CC or spinal neurostimulators $27,304 $27,304 $71,355 −62% $67,268 −59% —
574 Skin graft for skin ulcer or cellulitis with CC $27,125 $27,125 $44,605 −39% $52,036 −48% —
987 Non extensive O R proc unrelated to principal diagnosis w MCC $26,893 $26,893 $59,880 −55% $66,068 −59% —
037 Extracranial procedures with MCC $26,885 $26,885 $89,423 −70% $66,666 −60% —
477 Biopsies of musculoskeletal system and connective tissue with MCC $26,832 $26,832 $74,502 −64% $68,653 −61% —
252 Other vascular procedures with MCC $26,711 $26,711 $72,690 −63% $68,508 −61% —
579 Other skin subcutaneous tissue and breast procedures with MCC $26,619 $26,619 $45,498 −41% $58,745 −55% —
469 Maj hip knee jnt replace reattach low extrem w MCC or tot ank repl $26,520 $26,520 $45,618 −42% $65,788 −60% —
143 Other ear nose mouth and throat O R procedures with MCC $26,486 $26,486 $40,005 −34% $52,908 −50% —
260 Cardiac pacemaker revision except device replacement with MCC $26,404 $26,404 $78,755 −66% $70,371 −62% —
485 Knee procedures with principal diagnosis of infection with MCC $26,235 $26,235 $44,977 −42% $72,424 −64% —
264 Other circulatory system O R procedures $26,012 $26,012 $48,557 −46% $51,953 −50% —
904 Skin grafts for injuries with CC MCC $25,934 $25,934 $71,186 −64% $59,594 −56% —
500 Soft tissue procedures with MCC $25,827 $25,827 $45,424 −43% $61,872 −58% —
274 Percutaneous and other intracardiac procedures without MCC $25,811 $25,811 $57,726 −55% $65,573 −61% —
929 Full thickness burn w skin graft or inhalation injury w o CC MCC $25,610 $25,610 $44,472 −42% $44,472 −42% —
939 O R procedure w diagnoses of other contact w health services w MCC $25,608 $25,608 $44,389 −42% $55,289 −54% —
420 Hepatobiliary diagnostic procedures with MCC $25,493 $25,493 $49,003 −48% $50,919 −50% —
279 US accelerated other thrombolysis of peripheral vasc structures w o MCC $25,491 $25,491 $45,290 −44% $63,928 −60% —
229 Other cardiothoracic procedures without MCC $25,324 $25,324 $57,750 −56% $65,325 −61% —
515 Other musculoskeletal system connective tissue O R proc w MCC $25,180 $25,180 $92,826 −73% $62,821 −60% —
829 Myeloprolif disord or poorly diff neopl w oth proc w CC MCC $25,118 $25,118 $39,286 −36% $53,864 −53% —
656 Kidney and ureter procedures for neoplasm with MCC $24,989 $24,989 $45,479 −45% $65,608 −62% —
840 Lymphoma and non acute leukemia with MCC $24,890 $24,890 $51,930 −52% $49,710 −50% —
665 Prostatectomy with MCC $24,603 $24,603 $47,758 −48% $54,072 −54% —
173 Ultrasound accelerated and oth thrombolysis with PDX pulmonary embolism $24,491 $24,491 $56,209 −56% $60,407 −59% —
411 Cholecystectomy with C D E with MCC $24,215 $24,215 $67,831 −64% $48,358 −50% —
933 Extensive burns or full thick burns w MV 96 hours w o skin graft $24,148 $24,148 $59,352 −59% $59,352 −59% —
652 Kidney transplant $23,928 $23,928 $54,720 −56% $54,720 −56% —
464 Wnd debride skn grft exc hand for musculoskel conn tis dis w CC $23,904 $23,904 $56,193 −57% $58,228 −59% —
662 Minor bladder procedures with MCC $23,867 $23,867 $44,915 −47% $54,562 −56% —
521 Hip replacement with principal diagnosis of hip fracture with MCC $23,847 $23,847 $59,192 −60% $70,467 −66% —
324 Coronary intravascular lithotripsy with intraluminal device without MCC $23,643 $23,643 $91,834 −74% $71,464 −67% —
472 Cervical spinal fusion with CC $23,538 $23,538 $46,404 −49% $59,537 −60% —
026 Craniotomy and endovascular intracranial procedures with CC $23,520 $23,520 $63,310 −63% $64,523 −64% —
480 Hip and femur procedures except major joint with MCC $23,486 $23,486 $72,286 −68% $65,653 −64% —
353 Hernia procedures except inguinal and femoral with MCC $23,290 $23,290 $43,211 −46% $60,170 −61% —
570 Skin debridement with MCC $23,274 $23,274 $42,044 −45% $52,435 −56% —
625 Thyroid parathyroid and thyroglossal procedures with MCC $23,266 $23,266 $40,406 −42% $59,031 −61% —
974 HIV with major related condition with MCC $23,228 $23,228 $39,630 −41% $46,402 −50% —
406 Pancreas liver and shunt procedures with CC $22,996 $22,996 $54,796 −58% $58,043 −60% —
321 Perc CV proc with intralum device with MCC or 4 arteries intralum dev $22,895 $22,895 $67,943 −66% $81,706 −72% ≈111% of Medicare
462 Bilateral or multiple major joint procs of lower extremity w o MCC $22,669 $22,669 $40,363 −44% $58,975 −62% —
263 Vein ligation and stripping $22,501 $22,501 $38,005 −41% $51,253 −56% —
668 Transurethral procedures with MCC $22,444 $22,444 $41,045 −45% $51,608 −57% —
800 Splenic procedures with CC $22,441 $22,441 $41,012 −45% $49,184 −54% —
817 Other antepartum diagnoses with O R procedures with MCC $22,434 $22,434 $30,225 −26% $39,173 −43% —
240 Amputation for circulatory sys disorders exc upper limb toe w CC $22,374 $22,374 $54,475 −59% $59,790 −63% —
061 Ischemic stroke precereb occl trans ischemia w thrombolyt agt w MCC $22,323 $22,323 $67,651 −67% $62,264 −64% —
970 HIV with extensive O R procedures without MCC $22,138 $22,138 $37,631 −41% $44,222 −50% —
255 Upper limb toe amputation for circulatory system disorders w MCC $21,881 $21,881 $49,447 −56% $46,453 −53% —
344 Minor small and large bowel procedures with MCC $21,826 $21,826 $38,166 −43% $44,546 −51% —
654 Major bladder procedures with CC $21,803 $21,803 $39,822 −45% $58,274 −63% —
963 Other multiple significant trauma with MCC $21,777 $21,777 $38,454 −43% $43,491 −50% —
510 Shoulder elbow or forearm procedures exc major joint proc w MCC $21,668 $21,668 $40,289 −46% $49,839 −57% —
258 Cardiac pacemaker device replacement with MCC $21,572 $21,572 $39,606 −46% $52,986 −59% —
208 Respiratory system diagnosis with ventilator support 96 hours $21,534 $21,534 $59,696 −64% $52,405 −59% —
849 Radiotherapy $21,435 $21,435 $37,862 −43% $37,862 −43% —
013 Tracheostomy for face mouth neck diag or laryngectomy w o CC MCC $21,390 $21,390 $53,198 −60% $48,687 −56% —
503 Foot procedures with MCC $21,360 $21,360 $39,757 −46% $47,540 −55% —
468 Revision of hip or knee replacement without CC MCC $21,262 $21,262 $44,471 −52% $54,929 −61% —
135 Sinus and mastoid procedures with CC MCC $21,122 $21,122 $28,172 −25% $42,186 −50% —
577 Skin graft except for skin ulcer or cellulitis with CC $21,099 $21,099 $37,754 −44% $47,945 −56% —
325 Coronary intravascular lithotripsy without intraluminal device $21,060 $21,060 $72,297 −71% $61,217 −66% —
498 Local excision removal inter fixation dev hip femur w CC MCC $20,795 $20,795 $35,964 −42% $49,423 −58% —
619 O R procedures for obesity with MCC $20,727 $20,727 $65,002 −68% $51,746 −60% —
288 Acute and subacute endocarditis with MCC $20,652 $20,652 $71,241 −71% $50,618 −59% —
659 Kidney and ureter procedures for non neoplasm with MCC $20,619 $20,619 $44,554 −54% $52,178 −60% —
253 Other vascular procedures with CC $20,318 $20,318 $40,302 −50% $57,454 −65% —
164 Major chest procedures with CC $20,312 $20,312 $62,887 −68% $56,755 −64% —
347 Anal and stomal procedures with MCC $20,302 $20,302 $33,912 −40% $40,548 −50% —
959 Other O R procedures for multiple significant trauma w o CC MCC $20,169 $20,169 $46,181 −56% $41,422 −51% —
749 Other female reproductive system O R procedures with CC MCC $20,048 $20,048 $36,791 −46% $45,167 −56% —
113 Orbital procedures with CC MCC $19,969 $19,969 $45,171 −56% $36,167 −45% —
327 Stomach esophageal and duodenal procedures with CC $19,890 $19,890 $41,622 −52% $59,421 −67% —
545 Connective tissue disorders with MCC $19,857 $19,857 $38,759 −49% $40,362 −51% —
483 Major joint or limb reattachment procedures of upper extremities $19,785 $19,785 $47,785 −59% $58,707 −66% —
792 Prematurity without major problems $19,692 $19,692 $10,208 +93% $12,229 +61% —
473 Cervical spinal fusion without CC MCC $19,597 $19,597 $50,196 −61% $50,624 −61% —
846 Chemotherapy without acute leukemia as secondary diagnosis with MCC $19,465 $19,465 $36,339 −46% $38,878 −50% —
272 Other major cardiovascular procedures without CC MCC $19,429 $19,429 $42,404 −54% $55,162 −65% —
027 Craniotomy and endovascular intracranial procedures without CC MCC $19,377 $19,377 $71,258 −73% $54,583 −65% —
493 Lower extremity humerus procedures exc hip foot and femur w CC $19,128 $19,128 $61,840 −69% $59,651 −68% —
350 Inguinal and femoral hernia procedures with MCC $19,115 $19,115 $46,352 −59% $50,046 −62% —
056 Degenerative nervous system disorders with MCC $19,067 $19,067 $38,791 −51% $39,973 −52% —
095 Bacterial and tuberculous infections of nervous system with CC $18,989 $18,989 $50,347 −62% $47,583 −60% —
478 Biopsies of musculoskeletal system and connective tissue with CC $18,985 $18,985 $36,172 −48% $50,139 −62% —
674 Other kidney and urinary tract procedures with CC $18,973 $18,973 $41,721 −55% $50,394 −62% —
330 Major small and large bowel procedures with CC $18,892 $18,892 $50,487 −63% $59,500 −68% —
250 Percutaneous cardiovascular proc w o intraluminal device with MCC $18,723 $18,723 $41,205 −55% $59,629 −69% —
030 Spinal procedures without CC MCC $18,469 $18,469 $32,077 −42% $45,866 −60% —
417 Laparoscopic cholecystectomy without C D E with MCC $18,460 $18,460 $42,068 −56% $53,451 −65% —
827 Myeloprolif disord or poorly diff neopl w maj O R proc w CC $18,455 $18,455 $47,048 −61% $50,498 −63% —
035 Carotid artery stent procedures with CC $18,314 $18,314 $60,743 −70% $49,066 −63% —
082 Traumatic stupor and coma 1 hour with MCC $18,145 $18,145 $33,308 −46% $36,489 −50% —
243 Permanent cardiac pacemaker implant with CC $18,140 $18,140 $50,655 −64% $50,011 −64% —
085 Traumatic stupor and coma 1 hour with MCC $18,102 $18,102 $44,678 −59% $41,892 −57% —
629 Other endocrine nutritional and metabolic O R procedures with CC $18,022 $18,022 $49,188 −63% $47,737 −62% —
614 Adrenal and pituitary procedures with CC MCC $17,939 $17,939 $46,130 −61% $48,349 −63% —
397 Appendix procedures with MCC $17,893 $17,893 $35,353 −49% $53,257 −66% —
835 Acute leukemia with CC $17,804 $17,804 $36,186 −51% $35,569 −50% —
824 Lymphoma and non acute leukemia with other procedures with CC $17,784 $17,784 $53,048 −66% $41,608 −57% —
821 Lymphoma and leukemia with major O R procedures with CC $17,777 $17,777 $32,168 −45% $47,789 −63% —
041 Periph cranial nerve other nerv syst proc w CC or periph neurost $17,766 $17,766 $32,503 −45% $49,418 −64% —
320 Other endovascular cardiac valve procedures without MCC $17,729 $17,729 $37,349 −53% $40,060 −56% —
080 Nontraumatic stupor and coma with MCC $17,591 $17,591 $28,993 −39% $36,249 −51% —
715 Other male reproductive system O R proc for malignancy w CC MCC $17,581 $17,581 $32,504 −46% $38,998 −55% —
357 Other digestive system O R procedures with CC $17,496 $17,496 $42,646 −59% $48,682 −64% —
808 Major hematol immun diag exc sickle cell crisis coagul dis w MCC $17,443 $17,443 $36,743 −53% $39,181 −55% —
096 Bacterial and tuberculous infections of nervous system w o CC MCC $17,360 $17,360 $34,307 −49% $41,620 −58% —
595 Major skin disorders with MCC $17,323 $17,323 $30,646 −43% $34,598 −50% —
734 Pelvic evisceration rad hysterectomy and rad vulvectomy w CC MCC $17,311 $17,311 $44,334 −61% $42,795 −60% —
709 Penis procedures with CC MCC $17,289 $17,289 $32,359 −47% $34,535 −50% —
940 O R procedure w diagnoses of other contact w health services w CC $17,256 $17,256 $36,660 −53% $43,650 −60% —
286 Circulatory disorders except AMI w cardiac catheterization w MCC $17,168 $17,168 $44,619 −62% $46,283 −63% ≈113% of Medicare
098 Non bacterial infect of nervous system except viral meningitis w CC $17,159 $17,159 $39,731 −57% $42,901 −60% —
032 Ventricular shunt procedures with CC $17,154 $17,154 $37,711 −55% $46,724 −63% —
407 Pancreas liver and shunt procedures without CC MCC $17,131 $17,131 $66,230 −74% $46,727 −63% —
475 Amputation for musculoskeletal syst connective tissue dis w CC $17,081 $17,081 $31,193 −45% $45,877 −63% —
857 Postoperative or post traumatic infections w O R procedures w CC $17,010 $17,010 $38,932 −56% $45,333 −62% —
424 Other hepatobiliary or pancreas O R procedures with CC $16,978 $16,978 $44,472 −62% $42,415 −60% —
507 Major shoulder or elbow joint procedures with CC MCC $16,978 $16,978 $32,276 −47% $37,240 −54% —
814 Reticuloendothelial and immunity disorders with MCC $16,949 $16,949 $30,326 −44% $33,851 −50% —
711 Testes procedures with CC MCC $16,908 $16,908 $46,485 −64% $38,343 −56% —
522 Hip replacement with principal diagnosis of hip fracture w o MCC $16,822 $16,822 $50,107 −66% $58,280 −71% ≈116% of Medicare
146 Ear nose mouth and throat malignancy with MCC $16,813 $16,813 $48,893 −66% $40,108 −58% —
655 Major bladder procedures without CC MCC $16,787 $16,787 $44,278 −62% $43,174 −61% —
488 Knee procedures without principal diagnosis of infection w CC MCC $16,778 $16,778 $43,914 −62% $43,631 −62% —
336 Peritoneal adhesiolysis with CC $16,767 $16,767 $44,395 −62% $50,463 −67% —
374 Digestive malignancy with MCC $16,717 $16,717 $34,183 −51% $39,958 −58% —
314 Other circulatory system diagnoses with MCC $16,674 $16,674 $33,498 −50% $38,666 −57% —
934 Full thickness burn without skin graft or inhalation injury $16,666 $16,666 $31,044 −46% $31,044 −46% —
867 Other infectious and parasitic diseases diagnoses with MCC $16,664 $16,664 $31,004 −46% $38,070 −56% —
592 Skin ulcers with MCC $16,646 $16,646 $29,882 −44% $33,246 −50% —
333 Rectal resection with CC $16,562 $16,562 $32,771 −49% $37,154 −55% —
481 Hip and femur procedures except major joint with CC $16,525 $16,525 $50,338 −67% $52,751 −69% ≈115% of Medicare
141 Major head and neck procedures with CC $16,500 $16,500 $38,653 −57% $37,267 −56% —
412 Cholecystectomy with C D E with CC $16,455 $16,455 $56,706 −71% $42,906 −62% —
575 Skin graft for skin ulcer or cellulitis without CC MCC $16,295 $16,295 $21,809 −25% $29,611 −45% —
935 Non extensive burns $16,256 $16,256 $35,844 −55% $31,701 −49% —
516 Other musculoskeletal system connective tissue O R proc w CC $16,254 $16,254 $40,849 −60% $46,090 −65% —
854 Infectious and parasitic diseases with O R procedures with CC $16,233 $16,233 $32,044 −49% $43,943 −63% —
486 Knee procedures with principal diagnosis of infection with CC $15,995 $15,995 $49,467 −68% $49,351 −68% —
908 Other O R procedures for injuries with CC $15,961 $15,961 $38,919 −59% $42,914 −63% —
064 Intracranial hemorrhage or cerebral infarction with MCC $15,953 $15,953 $42,071 −62% $39,106 −59% ≈121% of Medicare
838 Chemo w acute leukemia as SDX w CC or high dose chemo agent $15,942 $15,942 $26,355 −40% $31,134 −49% —
511 Shoulder elbow or forearm procedures exc major joint proc w CC $15,879 $15,879 $36,710 −57% $43,538 −64% —
496 Local excision removal inter fixation dev exc hip femur w CC $15,829 $15,829 $35,865 −56% $43,800 −64% —
617 Amputation lower limb for endocrine nutrit metabolic disord w CC $15,805 $15,805 $41,821 −62% $42,881 −63% —
539 Osteomyelitis with MCC $15,805 $15,805 $45,071 −65% $37,609 −58% —
871 Septicemia or severe sepsis without MV 96 hours with MCC $15,790 $15,790 $36,465 −57% $35,628 −56% ≈113% of Medicare
100 Seizures with MCC $15,789 $15,789 $30,087 −48% $35,481 −55% ≈106% of Medicare
415 Cholecystectomy except by laparoscope without C D E with CC $15,736 $15,736 $32,506 −52% $43,913 −64% —
737 Uterine adnexa procedures for ovarian or adnexal malignancy w CC $15,720 $15,720 $38,786 −59% $44,363 −65% —
283 Acute myocardial infarction expired with MCC $15,701 $15,701 $39,782 −61% $39,955 −61% —
519 Back neck procedures except spinal fusion with CC $15,679 $15,679 $45,042 −65% $44,139 −64% —
707 Major male pelvic procedures with CC MCC $15,625 $15,625 $49,323 −68% $43,080 −64% —
584 Breast biopsy local excision and other breast procedures w CC MCC $15,599 $15,599 $34,148 −54% $35,030 −55% —
409 Biliary tract proc except only cholecystectomy w or w o C D E w CC $15,589 $15,589 $36,365 −57% $46,066 −66% —
548 Septic arthritis with MCC $15,529 $15,529 $29,341 −47% $31,346 −50% —
380 Complicated peptic ulcer with MCC $15,519 $15,519 $33,696 −54% $39,627 −61% —
052 Spinal disorders and injuries with CC MCC $15,487 $15,487 $52,533 −71% $32,031 −52% —
432 Cirrhosis and alcoholic hepatitis with MCC $15,260 $15,260 $48,837 −69% $40,213 −62% —
075 Viral meningitis with CC MCC $15,242 $15,242 $28,179 −46% $30,447 −50% —
196 Interstitial lung disease with MCC $15,096 $15,096 $31,016 −51% $32,637 −54% —
902 Wound debridements for injuries with CC $15,011 $15,011 $41,665 −64% $40,562 −63% —
744 D C conization laparoscopy and tubal interruption with CC MCC $14,992 $14,992 $29,667 −49% $38,861 −61% —
261 Cardiac pacemaker revision except device replacement with CC $14,987 $14,987 $34,861 −57% $42,126 −64% —
470 Major hip knee joint replace or reattach lower extremity w o MCC $14,987 $14,987 $43,106 −65% $50,607 −70% —
906 Hand procedures for injuries $14,986 $14,986 $31,520 −52% $32,065 −53% —
165 Major chest procedures without CC MCC $14,944 $14,944 $48,570 −69% $46,340 −68% —
883 Disorders of personality and impulse control $14,936 $14,936 $15,092 −1% $23,206 −36% —
722 Malignancy male reproductive system with MCC $14,932 $14,932 $25,633 −42% $29,826 −50% —
062 Ischemic stroke precereb occl trans ischemia w thrombolyt agt w CC $14,907 $14,907 $51,445 −71% $52,075 −71% —
465 Wnd debride skn grft exc hand for musculo conn tis dis w o CC MCC $14,900 $14,900 $25,727 −42% $32,443 −54% —
494 Lower extremity humerus proc exc hip foot and femur w o CC MCC $14,887 $14,887 $41,301 −64% $47,711 −69% —
259 Cardiac pacemaker device replacement without MCC $14,866 $14,866 $32,289 −54% $39,020 −62% —
479 Biopsies of musculoskeletal system and connective tissue w o CC MCC $14,846 $14,846 $26,242 −43% $34,276 −57% —
623 Skin grafts wound debride for endocrine nutrit metab disord w CC $14,825 $14,825 $28,020 −47% $34,459 −57% —
843 Other myeloprolif disord or poorly diff neoplastic diagnoses w MCC $14,819 $14,819 $36,319 −59% $36,431 −59% —
803 Other O R procedures of the blood and blood forming organs w CC $14,799 $14,799 $38,446 −62% $39,515 −63% —
941 O R proc w diagnoses of other contact w health services w o CC MCC $14,782 $14,782 $28,559 −48% $29,524 −50% —
754 Malignancy female reproductive system with MCC $14,754 $14,754 $26,677 −45% $32,433 −55% —
559 Aftercare musculoskeletal system and connective tissue with MCC $14,738 $14,738 $30,389 −52% $33,047 −55% —
657 Kidney and ureter procedures for neoplasm with CC $14,688 $14,688 $39,277 −63% $43,298 −66% —
862 Postoperative and post traumatic infections with MCC $14,670 $14,670 $33,224 −56% $32,859 −55% —
686 Kidney and urinary tract neoplasms with MCC $14,650 $14,650 $30,841 −52% $37,844 −61% —
116 Intraocular procedures with CC MCC $14,581 $14,581 $24,851 −41% $29,126 −50% —
244 Permanent cardiac pacemaker implant without CC MCC $14,571 $14,571 $44,198 −67% $41,591 −65% —
441 Disorders of liver exc malignancy cirrhosis or alc hepatitis w MCC $14,561 $14,561 $24,768 −41% $33,985 −57% —
919 Complications of treatment with MCC $14,533 $14,533 $26,862 −46% $31,105 −53% —
542 Pathological fractures musculoskeletal conn tissue malig w MCC $14,525 $14,525 $34,886 −58% $36,792 −61% —
322 Perc CV procedures with intraluminal device without MCC $14,522 $14,522 $53,246 −73% $58,809 −75% ≈118% of Medicare
167 Other respiratory system O R procedures with CC $14,494 $14,494 $41,640 −65% $40,642 −64% —
789 Neonates died or transferred to another acute care facility $14,490 $14,490 $21,045 −31% $16,351 −11% —
717 Other male reproductive system O R proc except malignancy w CC MCC $14,445 $14,445 $31,516 −54% $36,670 −61% —
205 Other respiratory system diagnoses with MCC $14,418 $14,418 $28,430 −49% $33,255 −57% —
036 Carotid artery stent procedures without CC MCC $14,401 $14,401 $55,123 −74% $40,694 −65% —
377 Gastrointestinal hemorrhage with MCC $14,259 $14,259 $38,041 −63% $37,842 −62% ≈116% of Medicare
801 Splenic procedures without CC MCC $14,254 $14,254 $32,979 −57% $36,445 −61% —
070 Nonspecific cerebrovascular disorders with MCC $14,252 $14,252 $25,761 −45% $31,951 −55% ≈120% of Medicare
091 Other disorders of nervous system with MCC $14,250 $14,250 $32,465 −56% $37,387 −62% —
740 Uterine adnexa proc for non ovarian non adnexal malignancy w CC $14,232 $14,232 $41,177 −65% $40,365 −65% —
742 Uterine and adnexa procedures for non malignancy with CC MCC $14,192 $14,192 $34,049 −58% $40,552 −65% —
896 Alcohol drug abuse or dependence w o rehabilitation therapy w MCC $14,162 $14,162 $22,819 −38% $31,159 −55% —
199 Pneumothorax with MCC $14,130 $14,130 $33,787 −58% $33,787 −58% —
915 Allergic reactions with MCC $14,129 $14,129 $25,750 −45% $32,645 −57% —
783 Cesarean section with sterilization with MCC $14,111 $14,111 $22,780 −38% $29,221 −52% —
435 Malignancy of hepatobiliary system or pancreas with MCC $14,017 $14,017 $34,822 −60% $37,950 −63% —
884 Organic disturbances and intellectual disability $13,993 $13,993 $24,125 −42% $26,682 −48% ≈110% of Medicare
786 Cesarean section without sterilization with MCC $13,934 $13,934 $22,460 −38% $27,152 −49% —
371 Major gastrointestinal disorders and peritoneal infections with MCC $13,919 $13,919 $29,997 −54% $33,555 −59% —
580 Other skin subcutaneous tissue and breast procedures with CC $13,911 $13,911 $26,907 −48% $38,101 −63% —
922 Other injury poisoning and toxic effect diagnoses with MCC $13,897 $13,897 $32,757 −58% $31,563 −56% —
582 Mastectomy for malignancy with CC MCC $13,868 $13,868 $25,923 −47% $35,849 −61% —
042 Peripheral cranial nerve other nervous system proc w o CC MCC $13,857 $13,857 $26,578 −48% $39,018 −64% —
180 Respiratory neoplasms with MCC $13,844 $13,844 $33,385 −59% $36,658 −62% —
501 Soft tissue procedures with CC $13,824 $13,824 $32,970 −58% $39,619 −65% —
254 Other vascular procedures without CC MCC $13,819 $13,819 $43,831 −68% $38,836 −64% —
144 Other ear nose mouth and throat O R procedures with CC $13,782 $13,782 $33,575 −59% $30,553 −55% —
058 Multiple sclerosis and cerebellar ataxia with MCC $13,762 $13,762 $27,152 −49% $30,243 −54% —
504 Foot procedures with CC $13,755 $13,755 $29,220 −53% $38,960 −65% —
354 Hernia procedures except inguinal and femoral with CC $13,681 $13,681 $39,779 −66% $43,477 −69% —
666 Prostatectomy with CC $13,678 $13,678 $29,763 −54% $31,906 −57% —
671 Urethral procedures with CC MCC $13,634 $13,634 $25,566 −47% $27,233 −50% —
421 Hepatobiliary diagnostic procedures with CC $13,616 $13,616 $64,566 −79% $36,354 −63% —
157 Dental and oral diseases with MCC $13,595 $13,595 $24,447 −44% $31,300 −57% —
505 Foot procedures without CC MCC $13,585 $13,585 $27,270 −50% $34,937 −61% —
551 Medical back problems with MCC $13,555 $13,555 $33,108 −59% $34,017 −60% —
855 Infectious and parasitic diseases with O R procedures w o CC MCC $13,554 $13,554 $24,143 −44% $28,202 −52% —
177 Respiratory infections and inflammations with MCC $13,511 $13,511 $33,707 −60% $33,707 −60% ≈118% of Medicare
571 Skin debridement with CC $13,475 $13,475 $37,317 −64% $37,169 −64% —
585 Breast biopsy local excision other breast procedures w o CC MCC $13,412 $13,412 $27,965 −52% $32,574 −59% —
886 Behavioral and developmental disorders $13,394 $13,394 $22,229 −40% $26,510 −49% —
746 Vagina cervix and vulva procedures with CC MCC $13,349 $13,349 $24,928 −46% $29,916 −55% —
331 Major small and large bowel procedures without CC MCC $13,317 $13,317 $38,599 −66% $44,117 −70% —
438 Disorders of pancreas except malignancy with MCC $13,291 $13,291 $21,375 −38% $32,628 −59% —
698 Other kidney and urinary tract diagnoses with MCC $13,176 $13,176 $30,494 −57% $32,496 −59% ≈123% of Medicare
368 Major esophageal disorders with MCC $13,157 $13,157 $32,526 −60% $33,876 −61% —
262 Cardiac pacemaker revision except device replacement without CC MCC $13,104 $13,104 $26,273 −50% $33,694 −61% —
643 Endocrine disorders with MCC $13,102 $13,102 $25,825 −49% $33,563 −61% —
828 Myeloprolif disord or poorly diff neopl w maj O R proc w o CC MCC $13,065 $13,065 $35,457 −63% $35,584 −63% —
865 Viral illness with MCC $13,061 $13,061 $22,350 −42% $26,910 −51% —
256 Upper limb toe amputation for circulatory system disorders w CC $13,059 $13,059 $25,176 −48% $32,944 −60% —
983 Extensive O R proc unrelated to principal diagnosis w o CC MCC $13,023 $13,023 $32,413 −60% $34,607 −62% —
418 Laparoscopic cholecystectomy without C D E with CC $13,019 $13,019 $33,278 −61% $44,606 −71% —
444 Disorders of the biliary tract with MCC $13,007 $13,007 $33,595 −61% $34,273 −62% —
533 Fractures of femur with MCC $12,993 $12,993 $22,986 −43% $25,945 −50% —
033 Ventricular shunt procedures without CC MCC $12,925 $12,925 $28,465 −55% $35,419 −64% —
620 O R procedures for obesity with CC $12,920 $12,920 $40,745 −68% $35,453 −64% —
513 Hand or wrist procedures exc major thumb or joint proc w CC MCC $12,910 $12,910 $22,744 −43% $33,424 −61% —
727 Inflammation of the male reproductive system with MCC $12,910 $12,910 $25,171 −49% $26,463 −51% —
393 Other digestive system diagnoses with MCC $12,899 $12,899 $30,510 −58% $34,192 −62% —
512 Shoulder elbow or forearm proc exc major joint proc w o CC MCC $12,853 $12,853 $34,657 −63% $35,692 −64% —
578 Skin graft except for skin ulcer or cellulitis without CC MCC $12,827 $12,827 $21,838 −41% $29,079 −56% —
895 Alcohol drug abuse or dependence with rehabilitation therapy $12,813 $12,813 $34,171 −63% $21,986 −42% —
334 Rectal resection without CC MCC $12,784 $12,784 $24,721 −48% $36,820 −65% —
296 Cardiac arrest unexplained with MCC $12,769 $12,769 $29,888 −57% $33,661 −62% —
425 Other hepatobiliary or pancreas O R procedures without CC MCC $12,758 $12,758 $23,257 −45% $26,598 −52% —
597 Malignant breast disorders with MCC $12,747 $12,747 $25,994 −51% $33,386 −62% —
038 Extracranial procedures with CC $12,742 $12,742 $35,924 −65% $35,770 −64% —
328 Stomach esophageal and duodenal procedures without CC MCC $12,722 $12,722 $41,638 −69% $39,006 −67% —
917 Poisoning and toxic effects of drugs with MCC $12,710 $12,710 $26,798 −53% $30,235 −58% —
482 Hip and femur procedures except major joint without CC MCC $12,651 $12,651 $39,675 −68% $41,955 −70% —
251 Percutaneous cardiovascular proc w o intraluminal device without MCC $12,639 $12,639 $38,157 −67% $46,295 −73% —
280 Acute myocardial infarction discharged alive with MCC $12,636 $12,636 $30,500 −59% $30,828 −59% ≈125% of Medicare
675 Other kidney and urinary tract procedures without CC MCC $12,636 $12,636 $25,169 −50% $34,749 −64% —
606 Minor skin disorders with MCC $12,630 $12,630 $30,798 −59% $27,975 −55% —
905 Skin grafts for injuries without CC MCC $12,613 $12,613 $24,586 −49% $25,197 −50% —
830 Myeloprolif disord or poorly diff neopl w oth proc w o CC MCC $12,593 $12,593 $48,926 −74% $31,170 −60% —
299 Peripheral vascular disorders with MCC $12,554 $12,554 $30,993 −59% $27,316 −54% —
183 Major chest trauma with MCC $12,540 $12,540 $23,796 −47% $29,933 −58% —
841 Lymphoma and non acute leukemia with CC $12,532 $12,532 $36,790 −66% $33,633 −63% —
385 Inflammatory bowel disease with MCC $12,479 $12,479 $24,282 −49% $27,617 −55% —
410 Biliary tract proc except only cholecyst w or w o C D E w o CC MCC $12,466 $12,466 $50,029 −75% $34,434 −64% —
115 Extraocular procedures except orbit $12,460 $12,460 $23,065 −46% $25,703 −52% —
564 Other musculoskeletal system and connective tissue diagnoses w MCC $12,440 $12,440 $33,452 −63% $33,653 −63% —
813 Coagulation disorders $12,425 $12,425 $32,291 −62% $33,296 −63% ≈208% of Medicare
557 Tendonitis myositis and bursitis with MCC $12,399 $12,399 $33,619 −63% $32,877 −62% —
186 Pleural effusion with MCC $12,362 $12,362 $35,284 −65% $33,834 −63% —
142 Major head and neck procedures without CC MCC $12,305 $12,305 $40,799 −70% $34,906 −65% —
487 Knee procedures with principal diagnosis of infection w o CC MCC $12,304 $12,304 $29,620 −58% $35,074 −65% —
769 Postpartum and post abortion diagnoses with O R procedures $12,296 $12,296 $21,228 −42% $25,094 −51% —
345 Minor small and large bowel procedures with CC $12,270 $12,270 $37,473 −67% $33,048 −63% —
154 Other ear nose mouth and throat diagnoses with MCC $12,251 $12,251 $27,330 −55% $27,633 −56% —
306 Cardiac congenital and valvular disorders with MCC $12,240 $12,240 $35,088 −65% $24,586 −50% —
669 Transurethral procedures with CC $12,222 $12,222 $36,359 −66% $34,354 −64% —
088 Concussion with MCC $12,216 $12,216 $21,503 −43% $24,402 −50% —
583 Mastectomy for malignancy without CC MCC $12,121 $12,121 $67,181 −82% $35,831 −66% —
562 Fracture sprain strain disloc exc femur hip pelvis thigh w MCC $12,111 $12,111 $23,984 −50% $29,743 −59% —
621 O R procedures for obesity without CC MCC $12,084 $12,084 $36,535 −67% $32,451 −63% —
398 Appendix procedures with CC $12,053 $12,053 $34,258 −65% $40,162 −70% —
073 Cranial and peripheral nerve disorders with MCC $12,050 $12,050 $28,480 −58% $30,010 −60% —
077 Hypertensive encephalopathy with MCC $12,033 $12,033 $29,789 −60% $24,550 −51% —
413 Cholecystectomy with C D E without CC MCC $12,023 $12,023 $39,618 −70% $29,316 −59% —
945 Rehabilitation with CC MCC $12,022 $12,022 $23,834 −50% $23,834 −50% —
604 Trauma to the skin subcutaneous tissue and breast with MCC $11,996 $11,996 $22,477 −47% $28,140 −57% —
137 Mouth procedures with CC MCC $11,984 $11,984 $21,600 −45% $27,861 −57% —
964 Other multiple significant trauma with CC $11,955 $11,955 $34,139 −65% $27,394 −56% —
682 Renal failure with MCC $11,953 $11,953 $27,301 −56% $29,064 −59% ≈128% of Medicare
337 Peritoneal adhesiolysis without CC MCC $11,918 $11,918 $32,469 −63% $39,211 −70% —
913 Traumatic injury with MCC $11,903 $11,903 $24,198 −51% $24,198 −51% —
517 Other musculoskeletal system conn tissue O R proc w o CC MCC $11,902 $11,902 $31,148 −62% $33,393 −64% —
626 Thyroid parathyroid and thyroglossal procedures with CC $11,882 $11,882 $25,547 −53% $33,454 −64% —
757 Infections female reproductive system with MCC $11,880 $11,880 $42,870 −72% $26,280 −55% —
794 Neonate with other significant problems $11,866 $11,866 $5,725 +107% $8,445 +41% —
602 Cellulitis with MCC $11,847 $11,847 $26,232 −55% $30,598 −61% —
063 Ischemic stroke precereb occ trans ischemia w thromb agt w o CC MCC $11,842 $11,842 $46,269 −74% $39,887 −70% —
658 Kidney and ureter procedures for neoplasm without CC MCC $11,791 $11,791 $36,253 −67% $36,253 −67% —
289 Acute and subacute endocarditis with CC $11,769 $11,769 $23,658 −50% $32,697 −64% —
054 Nervous system neoplasms with MCC $11,736 $11,736 $22,682 −48% $30,502 −62% —
615 Adrenal and pituitary procedures without CC MCC $11,716 $11,716 $43,042 −73% $32,833 −64% —
506 Major thumb or joint procedures $11,649 $11,649 $31,961 −64% $30,557 −62% —
663 Minor bladder procedures with CC $11,620 $11,620 $23,673 −51% $33,103 −65% —
708 Major male pelvic procedures without CC MCC $11,616 $11,616 $33,198 −65% $36,988 −69% —
351 Inguinal and femoral hernia procedures with CC $11,593 $11,593 $28,985 −60% $36,505 −68% —
388 Gastrointestinal obstruction with MCC $11,576 $11,576 $22,272 −48% $30,571 −62% —
713 Transurethral prostatectomy with CC MCC $11,554 $11,554 $28,808 −60% $32,100 −64% —
637 Diabetes with MCC $11,543 $11,543 $29,918 −61% $30,100 −62% ≈124% of Medicare
508 Major shoulder or elbow joint procedures without CC MCC $11,421 $11,421 $19,945 −43% $22,811 −50% —
520 Back neck procedures except spinal fusion without CC MCC $11,401 $11,401 $23,681 −52% $35,465 −68% —
818 Other antepartum diagnoses with O R procedures with CC $11,398 $11,398 $22,050 −48% $26,870 −58% —
497 Local excision removl int fixation dev exc hip femur w o CC MCC $11,368 $11,368 $20,619 −45% $29,805 −62% —
716 Other male reproductive system O R proc for malignancy w o CC MCC $11,327 $11,327 $21,615 −48% $22,620 −50% —
796 Vaginal delivery with sterilization and or D C with MCC $11,297 $11,297 $16,434 −31% $22,557 −50% —
067 Nonspecific CVA and precerebral occlusion without infarction w MCC $11,285 $11,285 $24,511 −54% $24,941 −55% —
693 Urinary stones with MCC $11,280 $11,280 $22,278 −49% $23,892 −53% —
977 HIV with or without other related condition $11,278 $11,278 $21,908 −49% $22,525 −50% —
836 Acute leukemia without CC MCC $11,245 $11,245 $19,686 −43% $19,686 −43% —
422 Hepatobiliary diagnostic procedures without CC MCC $11,238 $11,238 $62,451 −82% $25,073 −55% —
748 Female reproductive system reconstructive procedures $11,189 $11,189 $20,875 −46% $30,242 −63% —
811 Red blood cell disorders with MCC $11,179 $11,179 $24,954 −55% $28,226 −60% —
175 Pulmonary embolism with MCC or acute cor pulmonale $11,174 $11,174 $28,499 −61% $30,959 −64% ≈119% of Medicare
555 Signs and symptoms of musculoskeletal system conn tissue w MCC $11,142 $11,142 $22,253 −50% $24,127 −54% —
383 Uncomplicated peptic ulcer with MCC $11,136 $11,136 $21,076 −47% $27,426 −59% —
630 Other endocrine nutritional metabolic O R procedures w o CC MCC $11,121 $11,121 $21,381 −48% $22,393 −50% —
241 Amputation for circ sys disorders exc upper limb toe w o CC MCC $11,102 $11,102 $22,791 −51% $30,770 −64% —
502 Soft tissue procedures without CC MCC $11,012 $11,012 $29,865 −63% $31,017 −64% —
885 Psychoses $10,883 $10,883 $23,973 −55% $21,729 −50% —
509 Arthroscopy $10,880 $10,880 $25,994 −58% $25,994 −58% —
738 Uterine adnexa proc for ovarian or adnexal malignancy w o CC MCC $10,868 $10,868 $33,899 −68% $33,674 −68% —
975 HIV with major related condition with CC $10,858 $10,858 $25,319 −57% $27,808 −61% —
057 Degenerative nervous system disorders without MCC $10,857 $10,857 $29,561 −63% $27,543 −61% ≈121% of Medicare
355 Hernia procedures except inguinal and femoral without CC MCC $10,852 $10,852 $24,594 −56% $32,841 −67% —
750 Other female reproductive system O R procedures without CC MCC $10,832 $10,832 $19,930 −46% $27,989 −61% —
083 Traumatic stupor and coma 1 hour with CC $10,803 $10,803 $28,798 −62% $27,285 −60% —
909 Other O R procedures for injuries without CC MCC $10,802 $10,802 $28,736 −62% $28,156 −62% —
168 Other respiratory system O R procedures without CC MCC $10,797 $10,797 $29,843 −64% $29,949 −64% —
553 Bone diseases and arthropathies with MCC $10,764 $10,764 $26,469 −59% $26,051 −59% —
581 Other skin subcutaneous tissue and breast procedures w o CC MCC $10,726 $10,726 $22,149 −52% $26,932 −60% —
660 Kidney and ureter procedures for non neoplasm with CC $10,719 $10,719 $26,769 −60% $31,264 −66% ≈120% of Medicare
416 Cholecystectomy except by laparoscope without C D E without CC MCC $10,666 $10,666 $33,190 −68% $30,418 −65% —
193 Simple pneumonia and pleurisy with MCC $10,566 $10,566 $28,415 −63% $27,275 −61% ≈115% of Medicare
124 Other disorders of the eye with MCC or thrombolytic agent $10,528 $10,528 $21,894 −52% $21,894 −52% —
099 Non bacterial infect of nervous sys exc viral meningitis w o CC MCC $10,515 $10,515 $21,277 −51% $27,119 −61% —
086 Traumatic stupor and coma 1 hour with CC $10,490 $10,490 $23,278 −55% $27,043 −61% —
640 Misc disorders of nutrition metabolism fluids electrolyte w MCC $10,475 $10,475 $23,010 −54% $25,463 −59% ≈113% of Medicare
150 Epistaxis with MCC $10,469 $10,469 $28,054 −63% $23,171 −55% —
419 Laparoscopic cholecystectomy without C D E without CC MCC $10,459 $10,459 $36,603 −71% $36,937 −72% —
642 Inborn and other disorders of metabolism $10,380 $10,380 $19,302 −46% $20,727 −50% —
839 Chemotherapy w acute leukemia as secondary DX without CC MCC $10,378 $10,378 $17,291 −40% $20,980 −51% —
348 Anal and stomal procedures with CC $10,365 $10,365 $32,613 −68% $27,947 −63% —
741 Uterine adnexa proc for non ovarian non adnexal malig w o CC MCC $10,348 $10,348 $31,805 −67% $30,493 −66% —
540 Osteomyelitis with CC $10,339 $10,339 $19,990 −48% $26,676 −61% —
710 Penis procedures without CC MCC $10,332 $10,332 $22,681 −54% $26,436 −61% —
535 Fractures of hip and pelvis with MCC $10,327 $10,327 $25,858 −60% $24,552 −58% —
887 Other mental disorder diagnoses $10,319 $10,319 $18,631 −45% $20,616 −50% —
825 Lymphoma and non acute leukemia with other procedures w o CC MCC $10,285 $10,285 $19,169 −46% $27,323 −62% —
499 Local excision removal inter fixation dev hip femur w o CC MCC $10,273 $10,273 $18,260 −44% $21,230 −52% —
346 Minor small and large bowel procedures without CC MCC $10,257 $10,257 $19,263 −47% $27,297 −62% —
291 Heart failure and shock with MCC $10,226 $10,226 $27,424 −63% $26,776 −62% ≈119% of Medicare
858 Postop or post traumatic infections w O R procedures w o CC MCC $10,222 $10,222 $25,748 −60% $25,748 −60% —
121 Acute major eye infections with CC MCC $10,204 $10,204 $14,081 −28% $19,412 −47% —
358 Other digestive system O R procedures without CC MCC $10,203 $10,203 $28,020 −64% $30,083 −66% —
391 Esophagitis gastroenteritis misc digestive disorders w MCC $10,160 $10,160 $19,865 −49% $28,050 −64% —
735 Pelvic evisceration rad hysterectomy and rad vulvectomy w o CC MCC $10,037 $10,037 $18,949 −47% $26,948 −63% —
947 Signs and symptoms with MCC $9,968 $9,968 $23,898 −58% $27,401 −64% —
903 Wound debridements for injuries without CC MCC $9,888 $9,888 $19,017 −48% $25,581 −61% —
725 Benign prostatic hypertrophy with MCC $9,883 $9,883 $27,823 −64% $22,320 −56% —
822 Lymphoma and leukemia with major O R procedures without CC MCC $9,866 $9,866 $19,593 −50% $25,390 −61% —
489 Knee procedures without principal diagnosis of infection w o CC MCC $9,858 $9,858 $21,153 −53% $28,320 −65% —
627 Thyroid parathyroid and thyroglossal procedures without CC MCC $9,844 $9,844 $25,625 −62% $28,125 −65% —
147 Ear nose mouth and throat malignancy with CC $9,842 $9,842 $28,026 −65% $22,851 −57% —
189 Pulmonary edema and respiratory failure $9,812 $9,812 $24,603 −60% $26,580 −63% ≈114% of Medicare
114 Orbital procedures without CC MCC $9,811 $9,811 $23,224 −58% $19,598 −50% —
145 Other ear nose mouth and throat O R procedures without CC MCC $9,725 $9,725 $20,655 −53% $25,712 −62% —
768 Vaginal delivery with O R procedures exc sterilization and or D C $9,701 $9,701 $15,107 −36% $16,846 −42% —
847 Chemotherapy without acute leukemia as secondary diagnosis with CC $9,658 $9,658 $19,686 −51% $23,498 −59% —
804 Other O R procedures of blood and blood forming organs w o CC MCC $9,640 $9,640 $32,471 −70% $24,544 −61% —
593 Skin ulcers with CC $9,636 $9,636 $23,101 −58% $22,886 −58% —
102 Headaches with MCC $9,610 $9,610 $34,299 −72% $25,740 −63% —
549 Septic arthritis with CC $9,607 $9,607 $24,217 −60% $24,056 −60% —
809 Major hematol immun diag exc sickle cell crisis coagulat dis w CC $9,592 $9,592 $19,268 −50% $22,458 −57% —
308 Cardiac arrhythmia and conduction disorders with MCC $9,575 $9,575 $24,743 −61% $26,770 −64% ≈118% of Medicare
546 Connective tissue disorders with CC $9,552 $9,552 $32,794 −71% $25,700 −63% —
598 Malignant breast disorders with CC $9,548 $9,548 $18,578 −49% $19,073 −50% —
117 Intraocular procedures without CC MCC $9,545 $9,545 $17,193 −44% $17,193 −44% —
375 Digestive malignancy with CC $9,544 $9,544 $30,392 −69% $27,277 −65% —
695 Kidney and urinary tract signs and symptoms with MCC $9,525 $9,525 $28,352 −66% $24,566 −61% —
712 Testes procedures without CC MCC $9,465 $9,465 $17,076 −45% $18,898 −50% —
152 Otitis media and URI with MCC $9,463 $9,463 $17,922 −47% $20,247 −53% —
139 Salivary gland procedures $9,459 $9,459 $23,871 −60% $23,612 −60% —
059 Multiple sclerosis and cerebellar ataxia with CC $9,455 $9,455 $20,927 −55% $27,163 −65% —
476 Amputation for musculoskeletal syst conn tissue dis w o CC MCC $9,373 $9,373 $18,290 −49% $23,443 −60% —
718 Other male reproductive system O R proc exc malignancy w o CC MCC $9,365 $9,365 $19,183 −51% $19,270 −51% —
689 Kidney and urinary tract infections with MCC $9,353 $9,353 $18,916 −51% $23,617 −60% ≈123% of Medicare
743 Uterine and adnexa procedures for non malignancy without CC MCC $9,255 $9,255 $27,384 −66% $30,784 −70% —
618 Amputation lower limb for endocrine nutrit metabolic dis w o CC MCC $9,251 $9,251 $33,070 −72% $19,354 −52% —
844 Other myeloprolif disord or poorly diff neoplastic diagnoses w CC $9,216 $9,216 $18,707 −51% $21,847 −58% —
089 Concussion with CC $9,158 $9,158 $17,109 −46% $18,821 −51% —
304 Hypertension with MCC $9,151 $9,151 $24,714 −63% $26,080 −65% —
039 Extracranial procedures without CC MCC $9,087 $9,087 $31,640 −71% $26,618 −66% —
572 Skin debridement without CC MCC $9,076 $9,076 $22,256 −59% $24,944 −64% —
560 Aftercare musculoskeletal system and connective tissue with CC $9,017 $9,017 $23,785 −62% $25,279 −64% —
302 Atherosclerosis with MCC $8,929 $8,929 $21,279 −58% $22,446 −60% —
624 Skin grafts wound debride for endocr nutrit metab dis w o CC MCC $8,876 $8,876 $28,155 −68% $17,737 −50% —
723 Malignancy male reproductive system with CC $8,875 $8,875 $17,768 −50% $19,815 −55% —
399 Appendix procedures without CC MCC $8,865 $8,865 $25,475 −65% $31,321 −72% —
697 Urethral stricture $8,865 $8,865 $17,701 −50% $18,428 −52% —
352 Inguinal and femoral hernia procedures without CC MCC $8,833 $8,833 $29,044 −70% $27,843 −68% —
190 Chronic obstructive pulmonary disease with MCC $8,777 $8,777 $19,690 −55% $24,386 −64% ≈123% of Medicare
181 Respiratory neoplasms with CC $8,770 $8,770 $30,260 −71% $23,573 −63% —
436 Malignancy of hepatobiliary system or pancreas with CC $8,766 $8,766 $20,166 −57% $25,034 −65% —
294 Deep vein thrombophlebitis with CC MCC $8,711 $8,711 $19,132 −54% $19,132 −54% —
543 Pathological fractures musculoskeletal conn tissue malig w CC $8,687 $8,687 $18,503 −53% $23,551 −63% —
445 Disorders of the biliary tract with CC $8,656 $8,656 $20,142 −57% $23,319 −63% —
868 Other infectious and parasitic diseases diagnoses with CC $8,645 $8,645 $17,504 −51% $22,763 −62% —
290 Acute and subacute endocarditis without CC MCC $8,642 $8,642 $15,901 −46% $15,901 −46% —
755 Malignancy female reproductive system with CC $8,639 $8,639 $17,602 −51% $18,459 −53% —
287 Circulatory disorders except AMI w cardiac catheterization w o MCC $8,614 $8,614 $27,854 −69% $32,021 −73% —
989 Non extensive O R proc unrelated to principal diagnosis w o CC MCC $8,604 $8,604 $24,926 −65% $25,652 −66% —
200 Pneumothorax with CC $8,578 $8,578 $18,636 −54% $21,368 −60% —
831 Other antepartum diagnoses without O R procedures with MCC $8,564 $8,564 $18,133 −53% $18,133 −53% —
055 Nervous system neoplasms without MCC $8,547 $8,547 $18,849 −55% $20,926 −59% —
381 Complicated peptic ulcer with CC $8,546 $8,546 $23,283 −63% $24,177 −65% —
949 Aftercare with CC MCC $8,544 $8,544 $28,036 −70% $23,953 −64% —
300 Peripheral vascular disorders with CC $8,498 $8,498 $22,956 −63% $20,422 −58% ≈121% of Medicare
842 Lymphoma and non acute leukemia without CC MCC $8,493 $8,493 $20,494 −59% $19,657 −57% —
071 Nonspecific cerebrovascular disorders with CC $8,457 $8,457 $16,872 −50% $23,488 −64% —
644 Endocrine disorders with CC $8,456 $8,456 $23,815 −64% $23,198 −64% —
664 Minor bladder procedures without CC MCC $8,455 $8,455 $19,882 −57% $22,314 −62% —
184 Major chest trauma with CC $8,378 $8,378 $19,872 −58% $22,432 −63% —
787 Cesarean section without sterilization with CC $8,371 $8,371 $24,376 −66% $23,571 −64% —
667 Prostatectomy without CC MCC $8,359 $8,359 $16,534 −49% $16,703 −50% —
661 Kidney and ureter procedures for non neoplasm without CC MCC $8,350 $8,350 $18,935 −56% $25,970 −68% —
687 Kidney and urinary tract neoplasms with CC $8,325 $8,325 $16,857 −51% $20,232 −59% —
136 Sinus and mastoid procedures without CC MCC $8,317 $8,317 $15,890 −48% $17,404 −52% —
372 Major gastrointestinal disorders and peritoneal infections with CC $8,301 $8,301 $19,320 −57% $22,850 −64% ≈115% of Medicare
514 Hand or wrist procedures exc major thumb or joint proc w o CC MCC $8,295 $8,295 $16,427 −50% $22,635 −63% —
745 D C conization laparoscopy and tubal interruption without CC MCC $8,250 $8,250 $16,495 −50% $18,348 −55% —
920 Complications of treatment with CC $8,234 $8,234 $23,878 −66% $22,468 −63% —
433 Cirrhosis and alcoholic hepatitis with CC $8,211 $8,211 $21,094 −61% $23,749 −65% —
872 Septicemia or severe sepsis without MV 96 hours without MCC $8,203 $8,203 $18,180 −55% $22,888 −64% ≈124% of Medicare
074 Cranial and peripheral nerve disorders without MCC $8,173 $8,173 $16,950 −52% $23,141 −65% —
092 Other disorders of nervous system with CC $8,172 $8,172 $22,889 −64% $24,914 −67% —
600 Non malignant breast disorders with CC MCC $8,168 $8,168 $16,461 −50% $16,700 −51% —
784 Cesarean section with sterilization with CC $8,156 $8,156 $20,443 −60% $23,283 −65% —
699 Other kidney and urinary tract diagnoses with CC $8,130 $8,130 $20,153 −60% $21,275 −62% —
078 Hypertensive encephalopathy with CC $8,099 $8,099 $21,190 −62% $17,698 −54% —
065 Intracranial hemorrhage or cerebral infarction w CC or tPA in 24 hr $8,095 $8,095 $26,059 −69% $23,940 −66% ≈125% of Medicare
946 Rehabilitation without CC MCC $8,066 $8,066 $17,685 −54% $17,685 −54% —
923 Other injury poisoning and toxic effect diagnoses without MCC $8,055 $8,055 $16,813 −52% $17,601 −54% —
596 Major skin disorders without MCC $8,036 $8,036 $17,226 −53% $17,226 −53% —
805 Vaginal delivery without sterilization OR D C with MCC $8,030 $8,030 $13,876 −42% $15,370 −48% —
863 Postoperative and post traumatic infections without MCC $8,008 $8,008 $19,304 −59% $20,957 −62% —
810 Major hematol immun diag exc sickle cell crisis coagul w o CC MCC $8,000 $8,000 $21,101 −62% $18,316 −56% —
729 Other male reproductive system diagnoses with CC MCC $7,995 $7,995 $17,483 −54% $17,483 −54% —
565 Other musculoskeletal system and connective tissue diagnoses w CC $7,960 $7,960 $24,135 −67% $22,506 −65% —
197 Interstitial lung disease with CC $7,945 $7,945 $17,431 −54% $21,941 −64% —
187 Pleural effusion with CC $7,935 $7,935 $20,440 −61% $21,789 −64% —
797 Vaginal delivery with sterilization and or D C with CC $7,932 $7,932 $21,046 −62% $19,962 −60% —
760 Menstrual and other female reproductive system disorders w CC MCC $7,928 $7,928 $15,986 −50% $20,895 −62% —
815 Reticuloendothelial and immunity disorders with CC $7,918 $7,918 $19,264 −59% $19,264 −59% —
758 Infections female reproductive system with CC $7,905 $7,905 $16,992 −53% $20,901 −62% —
257 Upper limb toe amputation for circ sys disorders w o CC MCC $7,893 $7,893 $21,713 −64% $15,764 −50% —
756 Malignancy female reproductive system without CC MCC $7,882 $7,882 $15,589 −49% $15,589 −49% —
779 Abortion without D C $7,878 $7,878 $11,302 −30% $15,327 −49% —
369 Major esophageal disorders with CC $7,871 $7,871 $28,508 −72% $25,303 −69% —
178 Respiratory infections and inflammations with CC $7,858 $7,858 $20,753 −62% $22,024 −64% ≈122% of Medicare
053 Spinal disorders and injuries without CC MCC $7,835 $7,835 $15,153 −48% $20,455 −62% —
378 Gastrointestinal hemorrhage with CC $7,835 $7,835 $25,803 −70% $22,098 −65% ≈127% of Medicare
349 Anal and stomal procedures without CC MCC $7,772 $7,772 $18,669 −58% $19,854 −61% —
386 Inflammatory bowel disease with CC $7,738 $7,738 $17,764 −56% $22,033 −65% —
315 Other circulatory system diagnoses with CC $7,704 $7,704 $20,236 −62% $21,363 −64% —
537 Sprains strains dislocations of hip pelvis and thigh w CC MCC $7,702 $7,702 $16,936 −55% $18,072 −57% —
552 Medical back problems without MCC $7,696 $7,696 $21,141 −64% $21,396 −64% ≈118% of Medicare
670 Transurethral procedures without CC MCC $7,667 $7,667 $21,685 −65% $20,911 −63% —
714 Transurethral prostatectomy without CC MCC $7,634 $7,634 $17,944 −57% $17,934 −57% —
202 Bronchitis and asthma with CC MCC $7,626 $7,626 $16,255 −53% $17,724 −57% ≈122% of Medicare
965 Other multiple significant trauma without CC MCC $7,613 $7,613 $15,039 −49% $20,259 −62% —
880 Acute adjustment reaction and psychosocial dysfunction $7,603 $7,603 $20,399 −63% $17,733 −57% —
442 Disorders of liver exc malignancy cirrhosis or alc hepatitis w CC $7,578 $7,578 $20,528 −63% $21,449 −65% —
155 Other ear nose mouth and throat diagnoses with CC $7,539 $7,539 $15,869 −52% $16,968 −56% —
550 Septic arthritis without CC MCC $7,514 $7,514 $17,825 −58% $19,138 −61% —
307 Cardiac congenital and valvular disorders without MCC $7,507 $7,507 $22,213 −66% $20,566 −63% —
882 Neuroses except depressive $7,481 $7,481 $15,680 −52% $15,680 −52% —
158 Dental and oral diseases with CC $7,475 $7,475 $20,087 −63% $18,466 −60% —
672 Urethral procedures without CC MCC $7,467 $7,467 $17,398 −57% $17,398 −57% —
394 Other digestive system diagnoses with CC $7,462 $7,462 $18,918 −61% $20,181 −63% —
090 Concussion without CC MCC $7,445 $7,445 $25,638 −71% $15,412 −52% —
076 Viral meningitis without CC MCC $7,347 $7,347 $15,094 −51% $17,135 −57% —
084 Traumatic stupor and coma 1 hour without CC MCC $7,325 $7,325 $26,167 −72% $19,924 −63% —
866 Viral illness without MCC $7,309 $7,309 $16,845 −57% $17,081 −57% —
206 Other respiratory system diagnoses without MCC $7,276 $7,276 $16,722 −56% $18,488 −61% —
281 Acute myocardial infarction discharged alive with CC $7,272 $7,272 $24,435 −70% $20,463 −64% ≈122% of Medicare
101 Seizures without MCC $7,244 $7,244 $15,777 −54% $20,461 −65% ≈117% of Medicare
081 Nontraumatic stupor and coma without MCC $7,244 $7,244 $14,937 −52% $16,552 −56% —
605 Trauma to the skin subcutaneous tissue and breast without MCC $7,238 $7,238 $21,754 −67% $20,506 −65% —
914 Traumatic injury without MCC $7,229 $7,229 $15,088 −52% $15,855 −54% —
819 Other antepartum diagnoses with O R procedures without CC MCC $7,225 $7,225 $24,079 −70% $18,126 −60% —
881 Depressive neuroses $7,220 $7,220 $15,058 −52% $15,058 −52% —
683 Renal failure with CC $7,174 $7,174 $15,913 −55% $19,130 −62% ≈117% of Medicare
812 Red blood cell disorders without MCC $7,174 $7,174 $16,909 −58% $20,488 −65% ≈230% of Medicare
638 Diabetes with CC $7,163 $7,163 $18,494 −61% $19,661 −64% ≈131% of Medicare
060 Multiple sclerosis and cerebellar ataxia without CC MCC $7,147 $7,147 $18,799 −62% $22,148 −68% —
563 Fracture sprain strain dislo exc femur hip pelvis thigh w o MCC $7,133 $7,133 $18,854 −62% $19,842 −64% —
607 Minor skin disorders without MCC $7,116 $7,116 $15,276 −53% $15,889 −55% —
376 Digestive malignancy without CC MCC $7,099 $7,099 $18,015 −61% $16,998 −58% —
148 Ear nose mouth and throat malignancy without CC MCC $7,086 $7,086 $13,586 −48% $13,586 −48% —
747 Vagina cervix and vulva procedures without CC MCC $7,066 $7,066 $18,522 −62% $19,594 −64% —
087 Traumatic stupor and coma 1 hour without CC MCC $7,058 $7,058 $14,668 −52% $16,520 −57% —
603 Cellulitis without MCC $7,046 $7,046 $14,803 −52% $18,530 −62% ≈129% of Medicare
864 Fever and inflammatory conditions $7,031 $7,031 $26,826 −74% $18,640 −62% —
558 Tendonitis myositis and bursitis without MCC $6,996 $6,996 $19,672 −64% $18,602 −62% —
384 Uncomplicated peptic ulcer without MCC $6,974 $6,974 $17,796 −61% $19,305 −64% —
068 Nonspecific CVA and precerebral occlusion w o infarction w o MCC $6,937 $6,937 $20,241 −66% $19,569 −65% —
785 Cesarean section with sterilization without CC MCC $6,900 $6,900 $19,783 −65% $19,846 −65% —
138 Mouth procedures without CC MCC $6,895 $6,895 $13,752 −50% $19,119 −64% —
845 Other myeloprolif disord or poorly diff neoplastic diag w o CC MCC $6,888 $6,888 $14,055 −51% $14,055 −51% —
312 Syncope and collapse $6,877 $6,877 $17,340 −60% $19,342 −64% ≈123% of Medicare
918 Poisoning and toxic effects of drugs without MCC $6,857 $6,857 $12,276 −44% $15,452 −56% —
541 Osteomyelitis without CC MCC $6,833 $6,833 $14,882 −54% $15,215 −55% —
292 Heart failure and shock with CC $6,822 $6,822 $15,779 −57% $16,371 −58% —
897 Alcohol drug abuse or dependence w o rehabilitation thrpy w o MCC $6,814 $6,814 $14,644 −53% $16,699 −59% —
439 Disorders of pancreas except malignancy with CC $6,811 $6,811 $17,067 −60% $19,096 −64% —
788 Cesarean section without sterilization without CC MCC $6,810 $6,810 $21,303 −68% $20,084 −66% —
191 Chronic obstructive pulmonary disease with CC $6,762 $6,762 $14,338 −53% $18,807 −64% ≈122% of Medicare
976 HIV with major related condition without CC MCC $6,732 $6,732 $16,212 −58% $16,212 −58% —
103 Headaches without MCC $6,709 $6,709 $23,367 −71% $21,280 −68% —
848 Chemotherapy w o acute leukemia as secondary diagnosis w o CC MCC $6,660 $6,660 $13,822 −52% $14,501 −54% —
798 Vaginal delivery with sterilization and or D C without CC MCC $6,651 $6,651 $13,602 −51% $18,452 −64% —
437 Malignancy of hepatobiliary system or pancreas without CC MCC $6,619 $6,619 $16,463 −60% $14,014 −53% —
556 Signs and symptoms of musculoskeletal system conn tissue w o MCC $6,566 $6,566 $17,051 −61% $18,126 −64% —
547 Connective tissue disorders without CC MCC $6,557 $6,557 $19,855 −67% $16,565 −60% —
204 Respiratory signs and symptoms $6,554 $6,554 $22,720 −71% $18,004 −64% —
194 Simple pneumonia and pleurisy with CC $6,548 $6,548 $16,173 −60% $18,204 −64% ≈120% of Medicare
554 Bone diseases and arthropathies without MCC $6,545 $6,545 $19,424 −66% $18,528 −65% —
176 Pulmonary embolism without MCC $6,496 $6,496 $17,685 −63% $18,081 −64% ≈115% of Medicare
534 Fractures of femur without MCC $6,451 $6,451 $16,748 −61% $17,559 −63% —
724 Malignancy male reproductive system without CC MCC $6,447 $6,447 $19,038 −66% $12,768 −50% —
690 Kidney and urinary tract infections without MCC $6,426 $6,426 $16,665 −61% $17,674 −64% ≈129% of Medicare
123 Neurological eye disorders $6,403 $6,403 $24,638 −74% $19,745 −68% —
446 Disorders of the biliary tract without CC MCC $6,383 $6,383 $16,731 −62% $17,700 −64% —
948 Signs and symptoms without MCC $6,380 $6,380 $21,742 −71% $17,921 −64% —
728 Inflammation of the male reproductive system without MCC $6,372 $6,372 $13,799 −54% $17,118 −63% —
182 Respiratory neoplasms without CC MCC $6,362 $6,362 $14,064 −55% $14,064 −55% —
069 Transient ischemia without thrombolytic $6,361 $6,361 $16,890 −62% $21,056 −70% ≈128% of Medicare
770 Abortion with D C aspiration curettage or hysterotomy $6,361 $6,361 $17,159 −63% $18,956 −66% —
125 Other disorders of the eye without MCC $6,352 $6,352 $18,154 −65% $17,298 −63% —
295 Deep vein thrombophlebitis without CC MCC $6,348 $6,348 $13,445 −53% $13,445 −53% —
389 Gastrointestinal obstruction with CC $6,343 $6,343 $16,234 −61% $17,578 −64% ≈127% of Medicare
594 Skin ulcers without CC MCC $6,271 $6,271 $14,209 −56% $14,209 −56% —
536 Fractures of hip and pelvis without MCC $6,269 $6,269 $13,719 −54% $18,002 −65% —
392 Esophagitis gastroenteritis misc digestive disorders w o MCC $6,257 $6,257 $13,321 −53% $17,322 −64% ≈138% of Medicare
072 Nonspecific cerebrovascular disorders without CC MCC $6,236 $6,236 $24,325 −74% $19,037 −67% —
694 Urinary stones without MCC $6,234 $6,234 $13,336 −53% $17,345 −64% —
641 Misc disorder of nutrition metabolism fluid electrolyte w o MCC $6,223 $6,223 $15,817 −61% $17,038 −63% ≈126% of Medicare
688 Kidney and urinary tract neoplasms without CC MCC $6,219 $6,219 $17,790 −65% $12,593 −51% —
561 Aftercare musculoskeletal system and connective tissue w o CC MCC $6,214 $6,214 $14,554 −57% $18,150 −66% —
198 Interstitial lung disease without CC MCC $6,198 $6,198 $12,284 −50% $15,549 −60% —
093 Other disorders of nervous system without CC MCC $6,168 $6,168 $17,811 −65% $17,620 −65% —
151 Epistaxis without MCC $6,138 $6,138 $13,032 −53% $13,032 −53% —
544 Pathological fractures musculoskel conn tiss malig w o CC MCC $6,113 $6,113 $13,002 −53% $16,776 −64% —
179 Respiratory infections and inflammations without CC MCC $6,079 $6,079 $14,596 −58% $14,648 −58% —
645 Endocrine disorders without CC MCC $6,060 $6,060 $17,762 −66% $15,428 −61% —
382 Complicated peptic ulcer without CC MCC $6,030 $6,030 $15,817 −62% $16,634 −64% —
185 Major chest trauma without CC MCC $6,019 $6,019 $16,728 −64% $17,124 −65% —
305 Hypertension without MCC $6,001 $6,001 $19,959 −70% $18,086 −67% —
566 Other musculoskeletal system connective tiss diagnoses w o CC MCC $5,977 $5,977 $15,792 −62% $14,716 −59% —
806 Vaginal delivery without sterilization OR D C with CC $5,947 $5,947 $13,651 −56% $13,275 −55% —
188 Pleural effusion without CC MCC $5,945 $5,945 $12,723 −53% $14,514 −59% —
149 Dysequilibrium $5,931 $5,931 $23,926 −75% $18,096 −67% —
309 Cardiac arrhythmia and conduction disorders with CC $5,931 $5,931 $19,628 −70% $17,303 −66% ≈133% of Medicare
122 Acute major eye infections without CC MCC $5,930 $5,930 $11,072 −46% $11,997 −51% —
370 Major esophageal disorders without CC MCC $5,923 $5,923 $19,848 −70% $15,495 −62% —
079 Hypertensive encephalopathy without CC MCC $5,900 $5,900 $15,981 −63% $11,847 −50% —
284 Acute myocardial infarction expired with CC $5,891 $5,891 $15,776 −63% $16,450 −64% —
832 Other antepartum diagnoses without O R procedures with CC $5,875 $5,875 $12,595 −53% $12,895 −54% —
153 Otitis media and URI without MCC $5,852 $5,852 $13,931 −58% $14,583 −60% —
726 Benign prostatic hypertrophy without MCC $5,821 $5,821 $13,602 −57% $15,019 −61% —
297 Cardiac arrest unexplained with CC $5,803 $5,803 $12,336 −53% $12,336 −53% —
313 Chest pain $5,763 $5,763 $15,639 −63% $16,440 −65% —
282 Acute myocardial infarction discharged alive without CC MCC $5,719 $5,719 $18,651 −69% $19,227 −70% —
776 Postpartum and post abortion diagnoses without O R procedures $5,708 $5,708 $9,835 −42% $12,454 −54% —
373 Major gastrointestinal disorders peritoneal infections w o CC MCC $5,707 $5,707 $14,912 −62% $16,767 −66% —
443 Disorders of liver exc malignancy cirr or alc hepatitis w o CC MCC $5,692 $5,692 $21,770 −74% $15,600 −64% —
816 Reticuloendothelial and immunity disorders without CC MCC $5,656 $5,656 $12,745 −56% $14,638 −61% —
301 Peripheral vascular disorders without CC MCC $5,653 $5,653 $12,453 −55% $15,837 −64% —
538 Sprains strains dislocations of hip pelvis thigh w o CC MCC $5,648 $5,648 $13,441 −58% $11,909 −53% —
700 Other kidney and urinary tract diagnoses without CC MCC $5,641 $5,641 $16,196 −65% $14,797 −62% —
201 Pneumothorax without CC MCC $5,624 $5,624 $13,089 −57% $14,053 −60% —
311 Angina pectoris $5,560 $5,560 $14,117 −61% $15,502 −64% —
921 Complications of treatment without CC MCC $5,558 $5,558 $12,120 −54% $14,415 −61% —
203 Bronchitis and asthma without CC MCC $5,534 $5,534 $14,098 −61% $12,252 −55% —
316 Other circulatory system diagnoses without CC MCC $5,517 $5,517 $15,788 −65% $13,651 −60% —
696 Kidney and urinary tract signs and symptoms without MCC $5,512 $5,512 $12,411 −56% $14,689 −62% —
869 Other infectious and parasitic diseases diagnoses without CC MCC $5,501 $5,501 $15,122 −64% $12,559 −56% —
066 Intracranial hemorrhage or cerebral infarction without CC MCC $5,476 $5,476 $20,781 −74% $20,781 −74% —
387 Inflammatory bowel disease without CC MCC $5,448 $5,448 $14,044 −61% $16,288 −67% —
159 Dental and oral diseases without CC MCC $5,378 $5,378 $11,755 −54% $13,633 −61% —
599 Malignant breast disorders without CC MCC $5,358 $5,358 $14,290 −63% $14,290 −63% —
434 Cirrhosis and alcoholic hepatitis without CC MCC $5,332 $5,332 $14,866 −64% $12,460 −57% —
916 Allergic reactions without MCC $5,247 $5,247 $13,750 −62% $13,942 −62% —
303 Atherosclerosis without MCC $5,241 $5,241 $19,063 −73% $14,927 −65% —
156 Other ear nose mouth and throat diagnoses without CC MCC $5,221 $5,221 $11,921 −56% $14,549 −64% —
807 Vaginal delivery without sterilization OR D C without CC MCC $5,211 $5,211 $12,588 −59% $12,078 −57% —
395 Other digestive system diagnoses without CC MCC $5,157 $5,157 $16,504 −69% $14,128 −63% —
759 Infections female reproductive system without CC MCC $5,147 $5,147 $13,672 −62% $14,250 −64% —
192 Chronic obstructive pulmonary disease without CC MCC $5,112 $5,112 $16,076 −68% $14,368 −64% —
950 Aftercare without CC MCC $5,086 $5,086 $10,801 −53% $13,527 −62% —
601 Non malignant breast disorders without CC MCC $5,045 $5,045 $15,731 −68% $10,975 −54% —
379 Gastrointestinal hemorrhage without CC MCC $5,043 $5,043 $20,210 −75% $15,038 −66% —
195 Simple pneumonia and pleurisy without CC MCC $4,983 $4,983 $13,910 −64% $13,824 −64% —
639 Diabetes without CC MCC $4,958 $4,958 $15,601 −68% $13,910 −64% —
730 Other male reproductive system diagnoses without CC MCC $4,951 $4,951 $11,071 −55% $11,071 −55% —
440 Disorders of pancreas except malignancy without CC MCC $4,903 $4,903 $12,703 −61% $15,183 −68% —
684 Renal failure without CC MCC $4,846 $4,846 $11,276 −57% $13,642 −64% —
761 Menstrual and other female reproductive system disorders w o CC MCC $4,823 $4,823 $9,852 −51% $11,421 −58% —
951 Other factors influencing health status $4,699 $4,699 $11,914 −61% $10,160 −54% —
894 Alcohol drug abuse or dependence left AMA $4,576 $4,576 $11,294 −59% $12,324 −63% —
293 Heart failure and shock without CC MCC $4,472 $4,472 $10,316 −57% $12,999 −66% —
390 Gastrointestinal obstruction without CC MCC $4,452 $4,452 $10,472 −57% $13,361 −67% —
310 Cardiac arrhythmia and conduction disorders without CC MCC $4,404 $4,404 $12,015 −63% $13,384 −67% —
833 Other antepartum diagnoses without O R procedures without CC MCC $4,076 $4,076 $8,048 −49% $9,940 −59% —
285 Acute myocardial infarction expired without CC MCC $3,892 $3,892 $9,167 −58% $10,480 −63% —
298 Cardiac arrest unexplained without CC MCC $3,502 $3,502 $8,927 −61% $8,927 −61% —
795 Normal newborn $1,606 $1,606 $4,866 −67% $4,720 −66% —

Procedures with negotiated rates only

These 13 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
317 Concomitant left atrial appendage closure and cardiac ablation $49,444 – $61,311 · median $50,927 6 plans
402 Single level combined anterior and posterior spinal fusion exc cervical $31,406 – $38,943 · median $32,348 6 plans
426 Mult lvl comb ant pst spin fsn exc cerv w MCC or cust anat des fus dev $83,778 – $103,885 · median $86,292 6 plans
427 Multiple level comb ant pst spinal fusion except cervical with CC $56,739 – $70,357 · median $58,441 6 plans
428 Multiple level comb ant pst spinal fusion except cervical w o CC MCC $44,002 – $54,563 · median $45,323 6 plans
429 Combine anterior and posterior cervical spinal fusion with MCC $66,661 – $82,659 · median $68,661 6 plans
430 combine anterior and posterior cervical spinal fusion without MCC $43,722 – $54,215 · median $45,034 6 plans
447 Mult lvl spin fus exc cerv w MCC or vust anatom des interbody fus dev $53,586 – $66,447 · median $55,194 6 plans
448 Multiple level spinal fusion except cervical without MCC $32,637 – $40,469 · median $33,616 6 plans
450 Sing lvl spin fus exc cerv w MCC or cust anatom design inter fus dev $41,161 – $51,040 · median $42,396 6 plans
451 Single level spinal fusion except cervical without MCC $24,664 – $30,584 · median $25,404 6 plans
850 Acute Leukemia with other procedures $73,625 – $91,295 · median $75,834 6 plans
982 Extensive O R procedures unrelated to principal diagnosis w CC $19,571 – $24,268 · median $20,158 6 plans
← Back to Montefiore St. Luke's Cornwall profile